摘要
目的观察非小细胞肺癌（ＮＳＣＬＣ）加速超分割（ＨＡＲＴ）放疗的副反应及疗效。材料与方法１９９１年１２月～１９９４年１２月，６９例进入本研究（９例未完成放疗计划）。ＨＡＲＴ放疗，３次／天，１．１Ｇｙ／次，间隔４小时，总刑量７２－７６Ｇｙ／６６－６９次／３３（２９－４２）天。对照组（ＣＦＩ），１次／天，１．８－２．０Ｇｙ／次，总剂量６２－６５Ｇｙ／３２－３６次／４８（４５－５２）天。结果（１）急性放射性食管炎：ＨＡＲＴ组８７％（５２例），ＣＦＩ组４４％（２２例）（Ｐ＜０．００１）。（２）两组肺急性及后期放疗反应均无差异（Ｐ值均＞０．０５）。
Purpose In an attempt to improve local control and survival of non - small cell lung cancer ( NSCLC) , hyperfractionated accelerated radiation therapy ( HART ) was carried out as a clinical phase Ⅰ /Ⅱ trial . Materials and Methods HART was delivered by 1 . 1 Gy/fraction, three fractions per day with intervals of 4 hours and 5 treatment days per week. The clinical tumors were irradiated to 72 - 76 Gy/66 - 69 fx, 33 ( 29 - 42 ) days ( no lung density correction ) . Sixty - nine patients with NSCLC were enrolled in this study ( Nine patients were withdrawn from the study) . In order to compare the outcome of HART with conventional irradiation, 50 NSCLC patients treated by conventional irradiation ( CFI) during the same period were chosen as the control . They received tumor doses of 62 - 65 Gy in 48 ( 45 - 52 ) days at 1 . 8 - 2 . 0 Gy per fraction . Results ( 1 ) Acute and late complications, ( a) In HART 52 patients ( 87 % ) developed acute radiation esophagitis (RTOG Gradc I - Ⅱ) and in CFI,22 (44% ) ( P< 0. 001) . (b)There were no difference of acute pneumonitis and late lung morbidity in both groups . ( 2 ) Immediate response , In HART, 12 patients ( 20 % ) reached CR, 36 ( 60 % ) PR and 12(20%) NR orPD.IN CFl,the above three percentages were 10%,28% and 62%, respectively(P<0.001). (3) Long better local controls and less distant metastasis were obtained in HART The multivariate analyses using Cox model showed that HART improved the survival and local control rates, decrcase the distant metastasis. Conclusions ( 1 ) HART can be tolerated by most of the NSCLC patients. ( 2 ) HART results in better survival . local controls and less distant metastases than CFI .
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
1997年第2期94-98,共5页
Chinese Journal of Radiation Oncology
基金
肺癌国家八五攻关课题
关键词
非小细胞肺癌
放射治疗
加速超分割
NSCLC
HART
Non - small cell lung cancer Accelerated proliferation Radiotherapy Hyperfractionated accelerated irradiation
