常规设野与累及野照射局部晚期非小细胞癌的临床研究

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1、常规设野与累及野照射局部晚期非小细胞癌的临床研究【摘要】［目的］探讨局部晚期肺癌的放疗范围。［方法］87例局部晚期肺癌随机分为累及野组和常规野组,两组其他特征相似。［结果］全组中位生存时间12.00个月；1、2年总生存率分别为58.71%，17.93%,常规野组和累及野组疗效相似,1、2年生存率分别为59.31%,17.85%和57.86%,18.30%.(P>0.05),中位生存时间分别为12.14月和11.87月。常规野组和累及野组的治疗失败原因为病灶局部、远处转移、区域复发,分别为75.86%、55.17%、3.45%和70.27

2、%、56.76%、5.40%(P>0.05)。常规野放射性肺炎的发生率Ⅰ～Ⅱ级32.5%,Ⅱ～Ⅲ级15.00%,累及野组Ⅰ～Ⅱ级27.66%,Ⅱ～Ⅲ级14.89%.常规野组Ⅳ级放射性肺炎2例。［结论］部晚期肺癌给予常规野(预防淋巴结区)和累及野放疗,预后无明显改善,累及野可减轻放射性肺炎程度,建议累及野照射。【关键词】非小细胞肺癌;放射治疗;照射野;区域淋巴结　　Abstract:［Objective］Tostudytheoptionalfieldofradiotherapyforpatientswithlocallyadvancedn

3、onsmallcelllungcancer(NSCLC)byanalysisofrecurrencepatternswhenelectivelyunphnodeirradiationwasomitted.［Methods］87patientswithlocallyadvancedNSCLC,weredividedintotwo6groups.［Results］Allpatientscompletedthetreatmentwitharesponserateof80.00%and78.82%inconventionalfieldgroupan

4、dinvolvedfieldgroup,respectively.Ⅰ～Ⅱ,Ⅱ～Ⅲgradeofpneumoniaobservedinconventioualfieldgroupwas32.5%,20%versus27.66%,14.89%,respectively,ininvolvedfieldgroup.TwoofthosepatientsinconventionalfieldgrouphadⅣgradepneumonia.Theoverallsurvivalrateof1and2yearwas58.71%and17.93%,respe

5、ctively,withmediansurvivaltimeof12.00months.The1and2yearsurvivedraleinpatientswithconventionalfieldgroupandinvelvedfieldgvoup.was59.31%,17.85and57.86%,18.30%(P>0.05)withmediansurvivaltimeof12.14onouthsand11.87months,respectivelly.Thedifferencebetweenthetworadiotherapyw

6、asnosignificant(P>0.05).Infieldrecurences,distantrecurrencesandreginalrecurrencesdevelopedinconventionalfieldgroup75.86%,55.17%,3.45%,versus70.27%,56.76%,5.40%.［Conclusion］Omittingelectivelymphnodeirradiationdidnotcauseasignificantamountoffailureinlymphnoderegioninvolve

7、dintheclinicaltargetvolune,involvedfieldiradiationdidnotreducethesurvival.Therefore,wesuggestinvoledfieldirradiationinpatientswithNSCLC.6　　Keywords:NSCLC；radiotherapy;irradiationfieldsize；electivelymphnoderegion　　我国原发性肺癌的发病率明显上升,已成为恶性肿瘤的首位死因。其中,非小细胞肺癌(Nonsmallcelllungcance

8、r,NSCLC)的发病率占肺癌总数的75%～80%［1］。不可手术的中晚、晚期肺癌占了大多数,内约半数为局部广泛期的ⅢA、ⅢB期,其主要治疗方法为放疗。但对于放疗靶