全身伽玛刀联合DP方案治疗中晚期肺癌的疗效观察
Clinical Analysis of Whole Body Gamma Knife Combined with DP Regimen for Advanced Non-small Cell Lung Cancer
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摘要: 目的探讨全身伽玛刀联合DP方案同步化疗治疗中晚期非小细胞肺癌的近期疗效观察。方法120例患者均采用全身伽玛刀放疗,总量35~45 Gy,分10~14次完成,每日1次,每周5次;同步行全身化疗,采用DP方案,28天为一周期, 每位病人至少完成两周期化疗,伽玛刀治疗结束后3月评价疗效。结果120例患者近期总有效率(CR + PR)为85% ( 102/120) 。急性放射性肺损伤5.83% (7/120), 为1~2度;急性放射性食管损伤的发生率4.17% (5 /120), 为1~2度;血液毒性主要为白细胞下降,3度发生率为3.33% (4/120), 无4度血液毒性发生。随访24月,6、12、24月生存率分别为85.83% (103 /120) 、54.17% (65/120)、39.17%(47/120)。结论采用全身伽玛刀联合同步化疗治疗中晚期肺癌,具有较高的临床疗效,不良反应较轻,患者可以耐受。Abstract: ObjectiveTo observe the short-term curative effects of whole body gamma knife combined with concurrent chemotherapy for treatment of advanced non-small cell lung cancer(NSCLC) . Methods All 120 patients were treated with whole body gamma knife combined with concurrent chemotherapy.Radiation was delivered in 10 to 14 fractions with a cumulated marginal dose ranged 35~45 Gy.DP project were given with whole body gamma knife,28d per cycle.At least 2 cycles were delivered.Clinical effects were evaluated 3 months after whole body gamma knife treatment. Results The total efficacy rate was 85.00% ( 102/120 ) .Acute radiation induced lung injury was 5.83% (7/120)(Ⅰ~Ⅱ) ; acute radiation induced esophagus injury was 4.17% (5/120)( Ⅰ~Ⅱ) ; bone marrow toxicity 12.50% (Ⅲ).In the follow up of 24 months,the survival rates at 6,12 and 24 months were 85.83% (103/120),54.17% (65/120) and 39.17%(47/120),respectively. Conclusion Whole body gamma knife combined with concurrent chemotherapy is a feasible,safe,and effective method and could be well tolerated in most patients.It is a good treatment for patients with advanced lung cancer and deserves further investigation.