摘要
目的:观察立体定向伽玛射线(体部伽玛刀)治疗中晚期非小细胞肺癌的疗效,探讨体部伽马刀在治疗非小细胞肺癌的临床价值。方法:将96例采用体部伽玛刀治疗III-IV期非小细胞肺癌。治疗剂量3.5~4.2Gy/次,每日1次,5次/周,一般治疗10次,平均剂量6 000~7 200c Gy,最大剂量点8 500c Gy,随访6~24个月。分别用RECIST1.1评价标准进行近期疗效评价。结果:96例患者1、3、6个月原发肿瘤病灶完全缓解分别为20.83%、26.04%、27.08%;总有效率为78.13%、89.58%、91.67%。1年总生存率为73.96%,2年生存率为60.42%,差异具有统计学意义(P<0.05)。放疗后患者情绪功能、咳嗽和呼吸困难得到明显改善,与放疗前比较,差异有统计学意义(P<0.05)。体部伽玛刀治疗期间的主要不良反应为胃肠道反应、放射性肺损伤、反射性食管炎。结论:体部伽玛刀作为一种有效安全的局部治疗手段,对中晚期非小细胞肺癌具有较好的治疗效果,同时放射毒副反应的发生程度较轻,患者的接受性高,具有有效的提高局部控制率和生存率,且并发症发生率低。
Objective： To observe the curative effect of middle-late stage non-small cell lung cancer treated with the three-dimensional stereotactic gamma rays（body gamma knife）,and explore the clinical value of body gamma knife in the treatment III-IV of non-small cell lung cancer.Methods： Treatment dose of 3.5 - 4.2Gy / times,1times a day,five times per week,general treatment 10 times,the average dose of 6 000 - 7 200 cGy,maximum dose point 8 500 cGy,followed up for 6 - 24 months.With RECIST1.1 evaluation standard for the recent curative effect evaluation.Results： The 1,3 and,6-month year complete response rates were 20.83%,26.04%,27.08%,and the overall response rates were 78.13%,89.58%,9 1.6 7 %,respectively.The 1,2-year overall survival rates were73.96% and 60.42%,respectively（p〈0.05）.The emotional function,cough,difficulty breathing were improved significantly after treatment（p〈0.05）.The adverse reactions were gastrointestinal reaction,radioactive lung injury,radioactive esophagitis.Conclusion： Body gamma knife treatment effect for locally advanced non-small cell lung cancer curative is satisfied,and has light radiation side effects,acceptable for middle-late patients.Partial treatment is an effective security,can effectively improve the local control and survival rate,with low complication rates.
出处
《现代肿瘤医学》
CAS
2017年第8期1220-1223,共4页
Journal of Modern Oncology
基金
南京军区医学科技创新重点课题资助项目(编号:15ZD011)
关键词
中晚期非小细胞肺癌
体部伽玛刀
放射治疗
middle-late stage non-small cell lung cancer
body gamma knife
radiotherapy
