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不同时期治疗的Ⅲ期非小细胞肺癌三维适形放疗的靶区剂量分布及疗效比较

王玉祥, 田丹丹, 邱 嵘, 祝淑钗, 乔学英

王玉祥, 田丹丹, 邱 嵘, 祝淑钗, 乔学英. 不同时期治疗的Ⅲ期非小细胞肺癌三维适形放疗的靶区剂量分布及疗效比较[J]. 肿瘤防治研究, 2014, 41(05): 413-417. DOI: 10.3971/j.issn.1000-8578.2014.05.015
引用本文: 王玉祥, 田丹丹, 邱 嵘, 祝淑钗, 乔学英. 不同时期治疗的Ⅲ期非小细胞肺癌三维适形放疗的靶区剂量分布及疗效比较[J]. 肿瘤防治研究, 2014, 41(05): 413-417. DOI: 10.3971/j.issn.1000-8578.2014.05.015
WANG Yuxiang, TIAN Dandan, QIU Rong, ZHU Shuchai, QIAO Xueying. Comparison of Target Dose Distribution and Efficacy of 3D-CRT on Stage Ⅲ NSCLC in Different Periods[J]. Cancer Research on Prevention and Treatment, 2014, 41(05): 413-417. DOI: 10.3971/j.issn.1000-8578.2014.05.015
Citation: WANG Yuxiang, TIAN Dandan, QIU Rong, ZHU Shuchai, QIAO Xueying. Comparison of Target Dose Distribution and Efficacy of 3D-CRT on Stage Ⅲ NSCLC in Different Periods[J]. Cancer Research on Prevention and Treatment, 2014, 41(05): 413-417. DOI: 10.3971/j.issn.1000-8578.2014.05.015

不同时期治疗的Ⅲ期非小细胞肺癌三维适形放疗的靶区剂量分布及疗效比较

详细信息
    作者简介:

    王玉祥(1969-),男,博士,教授,主要从事食管癌和肺癌放疗基础与临床研究

  • 中图分类号: R734.2

Comparison of Target Dose Distribution and Efficacy of 3D-CRT on Stage Ⅲ NSCLC in Different Periods

  • 摘要: 目的 比较不同时期治疗的Ⅲ期非小细胞肺癌(NSCLC)三维适形放疗(3D-CRT)的靶区剂量分布、疗效及不良反应。方法 回顾性分析203例Ⅲ期非小细胞肺癌患者的3D-CRT临床资料,其中72例2000年8月—2004年12月治疗者为A组,131例2006年10月—2008年12月治疗者为B组。A和B组等效中位剂量为66 Gy和60 Gy。采用放疗计划系统评价剂量分布,SPSS13.0软件统计分析。结果 A和B组物理参数比较,A组GTV、CTV和PTV的Dmax、Dmean、V65明显高于B组(P<0.05);GTVV50,CTVD95、CTVV60~50,PTVD100~90、PTVV55~50,B组明显高于A组(P<0.05);GTVD100~90、GTVV60~55、CTVD90和CTVV60、PTVV60在两组差异无统计学意义(P>0.05)。A 组肺、心脏和脊髓受照剂量以及急性期放射性肺炎和食管炎的发生率明显高于B组(P<0.05)。全组放疗后1、3、5年总生存率分别为54.6%、18.8%、14.5%。A组和B组1、3、5年生存率分别为45. 8%、15.3%、10.5%和59.3%、20.8、16.9% (P<0.05)。结论 随着三维适形放疗技术应用的日益成熟,Ⅲ期NSCLC靶区剂量分布更合理,在降低放疗处方剂量、减少放疗不良反应的同时,肿瘤靶区实际受照剂量和放疗疗效并没有明显下降。

     

    Abstract: Objective To compare the dose parameters, efficacy and adverse reaction of stage Ⅲ nonsmall cell lung cancer (NSCLC) patients treated with three-dimensional conformal radiotherapy (3D-CRT) in different periods. Methods Two hundred and three patients with stage Ⅲnon-small cell lung cancer (NSCLC) treated with 3D-CRT were divided into two groups, 72 patients treated from August 2000 to December 2004 (Group A) and the rest of 131 patients treated from October 2006 to December 2008 (Group B). Median and biological effective doses were 66 and 60 Gy for Group A and B, respectively. The dose parameters were evaluated by treatment planning system with software SPSS13.0. Results Dmax, Dmean and V65 of GTV, CTV and PTV of Group A were higher than those of Group B(P<0.05). GTVV50, CTVD95, CTVV60-50, PTVD100-90 and PTVV55-50 of Group B were higher than those of Group A(P<0.05). No signifi cant difference was found in GTVD100-90, GTVV60-55, CTVD90, CTVV60 and PTVV60 between two groups(P>0.05). The irradiated doses to lung, heart and spinal cord, and the occurrence rate of acute radiation induced pneumonitis and esophagitis in Group A were significantly higher than those in Group B(P<0.05). The 1-, 3-, 5-years and median overall survival (OS) were 54.6%, 18.8%, 14.5% and 14 months in the whole group. The corresponding survival rates of Group A were 54.6%, 18.8%, 14.5% and 14 months and those of Group B were 59.3%, 20.8, 16.9% and 18 months (χ2=4.409, P=0.036) respectively. There was no signifi cant OS difference between radiotherapy alone and combined chemo-radiotherapy (χ2=1.43, P=0.232). Conclusion With application of 3D-CRT got more mature, the dose distribution in stage Ⅲ NSCLC became more optimal.As planing dose and adverse reaction occurrence were decreased the actual tumor dose or clinical effi cacy was not sacrifi ced.

     

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出版历程
  • 收稿日期:  2013-03-13
  • 修回日期:  2013-09-01
  • 刊出日期:  2014-05-24

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