老年非小細胞肺癌大分割三維適形放療長期隨訪結果_《華西醫學》

作者：

成都軍區總醫院放療科,四川成都 610083;

關鍵詞：

老年人非小細胞肺癌大分割放療三維適形放療

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目的:評價70歲以上老年非小細胞肺癌患者大分割放療的長期療效和并發癥。方法:對1997年8月至2003年2月收治的38例70歲以上非小細胞肺癌實施大分割三維適形放療(3D-CRT),年齡70～85歲,中位年齡74歲。全組卡氏評分均≥70。其中Ⅰ期8例, Ⅱ期20例, Ⅲ期8例,Ⅳ期2例。結果:全組有效率(CR+PR)92.1%;1,2,3,5年生存率分別為94.7%、65.7%、38.9% 和 28.0%。1,2 級急性放射性食管炎發生率 47.4%(18/38);未出現急性癥狀性放射性肺炎,未發現嚴重心臟、食管、脊髓放射性反應。晚期局部肺放射性纖維化表現(CT和/或胸片)為34.2%(13/38).結論:不能手術的老年非小細胞肺癌患者大分割適形放射治療,安全有效,副作用可以耐受。

引用本文： 駱建華,咸婧,潘興國,李小凱,葉巍,劉學生. 老年非小細胞肺癌大分割三維適形放療長期隨訪結果. 華西醫學, 2009, 24(6): 1412-1415. doi: 復制

1.	羅揚,郝學志,張湘茹.老年晚期非小細胞肺癌的化療可行性[J].腫瘤防治研究,2002,29(3):238-240.
2.	楊志雄,梁榮,黃杰,等.放化聯合治療老年非小細胞肺癌的可行性[J].腫瘤防治研究,2003,30(3):228-230.
3.	TOMBOLINI V,BONANNI A,DONATO V, et al. Radiotherapy alone in eldely patients with medically inoperable stage ⅢA and ⅢB nonsmall cell lung cancer [J].Antican Res,2000,20 (60):4829-4833.
4.	MOVSAS B,SCOTT C,SAUSE W, et al. The benefit of treatment intensification is age and histologypendent in patients with locally advanced nonmall cell lung cancer (NSCLC):a quality adjusted survival analysis of radiation therapy oncology group (RTOG) chemoradiation studies [J]. Int J Radiat Oncol Biol Phys,1999,45 (5):1143-1149.
5.	SCHILD SE, STELLA PJ, GEYER SM, et al. The outcome of combinedmodality therapy for stage Ⅲ nonsmall cell lung cancer in the elderly[J]. J Clin Oncol,2003,21 (17):3201-3206.
6.	MARTEL MK,TEN HAKEN RK, HAZUKA MB, et al. Estimation of tumor control probability model parameters from 3D dose distributions of nonsmall cell lung cancer patients [J].J Lung cancer,1999,24:31-37.
7.	陳龍華.59例腫瘤立體定向適形放療的初步經驗[J]. J廣東醫學,1999,20(10):755-756.
8.	王淑蓮,劉躍平,孫倩. 放射腫瘤學——治療策略與實施. 天津科技翻譯出版公司,2001,14.
9.	CHEUNG PC, M ACKILLOP WJ, DIXON P, et al.Involvedfield radiotherapy alon for earlystage nonsmallcell lung caner. [J].Int J Radiat Oncol Biol Phys 2000,48:703-710.
10.	MAGUIRE PD,MARKS LB, SIBLEY GS, et al.736Gy and beyond hyperfractionated accelerated radiotherapy for nonsmallcall lung cancer [J]. [11]KONG FM, TEN HAKEN RK, SCHIPPERMJ, et al. Highdose radiation improed local tumor control and survival in patients with inoperable /unresectable nonsmall cell lung cancer: longterm result of a radiation dose escalation study [J]. Int J Radiat Oncol Biol Phys,2005,63(2):3242-3331.
11.	劉子瑩,盧冰,歐陽偉煒,等.早期非小細胞肺癌大分割放射治療臨床研究[J].J腫瘤預防與治療,2008,(21)2:152-154.
12.	CHEN M, JIANG GL, FU XL, et al.The impact of overall treatment time on outcomes in radiation therapy for nonsmallcell lung cancer.Lung Cancer 2000,28:11-19.
13.	駱建華,曾興炳,潘興國,等.非小細胞肺癌常規外照射結合三維適形照射的臨床研究[J].J四川醫學2004,9(25):980-981.
14.	吳開良,蔣國梁,廖源,等.非小細胞肺癌三維放射適形放射治療I和Ⅱ期劑量遞增實驗結果分析 [J].中華放射腫瘤學雜志,2003,1(1)10-13.
15.	HIR OSHI O, YASUSHI N, HIR OKI S, et al. Stereotactic Hypofractionated highdose irradiation for patients with stage I non mall cell lung carcinoma: clinical outcomes in 241 cases of a Japanese multiinstitutionalstudy[J]. (Abstr) Int J Radiat Oncol Biol Phys, 2003,57:S124.

1. 羅揚,郝學志,張湘茹.老年晚期非小細胞肺癌的化療可行性[J].腫瘤防治研究,2002,29(3):238-240.
2. 楊志雄,梁榮,黃杰,等.放化聯合治療老年非小細胞肺癌的可行性[J].腫瘤防治研究,2003,30(3):228-230.
3. TOMBOLINI V,BONANNI A,DONATO V, et al. Radiotherapy alone in eldely patients with medically inoperable stage ⅢA and ⅢB nonsmall cell lung cancer [J].Antican Res,2000,20 (60):4829-4833.
4. MOVSAS B,SCOTT C,SAUSE W, et al. The benefit of treatment intensification is age and histologypendent in patients with locally advanced nonmall cell lung cancer (NSCLC):a quality adjusted survival analysis of radiation therapy oncology group (RTOG) chemoradiation studies [J]. Int J Radiat Oncol Biol Phys,1999,45 (5):1143-1149.
5. SCHILD SE, STELLA PJ, GEYER SM, et al. The outcome of combinedmodality therapy for stage Ⅲ nonsmall cell lung cancer in the elderly[J]. J Clin Oncol,2003,21 (17):3201-3206.
6. MARTEL MK,TEN HAKEN RK, HAZUKA MB, et al. Estimation of tumor control probability model parameters from 3D dose distributions of nonsmall cell lung cancer patients [J].J Lung cancer,1999,24:31-37.
7. 陳龍華.59例腫瘤立體定向適形放療的初步經驗[J]. J廣東醫學,1999,20(10):755-756.
8. 王淑蓮,劉躍平,孫倩. 放射腫瘤學——治療策略與實施. 天津科技翻譯出版公司,2001,14.
9. CHEUNG PC, M ACKILLOP WJ, DIXON P, et al.Involvedfield radiotherapy alon for earlystage nonsmallcell lung caner. [J].Int J Radiat Oncol Biol Phys 2000,48:703-710.
10. MAGUIRE PD,MARKS LB, SIBLEY GS, et al.736Gy and beyond hyperfractionated accelerated radiotherapy for nonsmallcall lung cancer [J]. [11]KONG FM, TEN HAKEN RK, SCHIPPERMJ, et al. Highdose radiation improed local tumor control and survival in patients with inoperable /unresectable nonsmall cell lung cancer: longterm result of a radiation dose escalation study [J]. Int J Radiat Oncol Biol Phys,2005,63(2):3242-3331.
11. 劉子瑩,盧冰,歐陽偉煒,等.早期非小細胞肺癌大分割放射治療臨床研究[J].J腫瘤預防與治療,2008,(21)2:152-154.
12. CHEN M, JIANG GL, FU XL, et al.The impact of overall treatment time on outcomes in radiation therapy for nonsmallcell lung cancer.Lung Cancer 2000,28:11-19.
13. 駱建華,曾興炳,潘興國,等.非小細胞肺癌常規外照射結合三維適形照射的臨床研究[J].J四川醫學2004,9(25):980-981.
14. 吳開良,蔣國梁,廖源,等.非小細胞肺癌三維放射適形放射治療I和Ⅱ期劑量遞增實驗結果分析 [J].中華放射腫瘤學雜志,2003,1(1)10-13.
15. HIR OSHI O, YASUSHI N, HIR OKI S, et al. Stereotactic Hypofractionated highdose irradiation for patients with stage I non mall cell lung carcinoma: clinical outcomes in 241 cases of a Japanese multiinstitutionalstudy[J]. (Abstr) Int J Radiat Oncol Biol Phys, 2003,57:S124.

《華西醫學》

老年非小細胞肺癌大分割三維適形放療長期隨訪結果

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《華西醫學》

老年非小細胞肺癌大分割三維適形放療長期隨訪結果

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