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目的 :评价后程加速超分割放射治疗不能手术Ⅲ期非小细胞肺癌的疗效。方法 :从 1996年 8月至1999年 2月 ,经病理组织学或细胞学确诊的 70例不能手术的Ⅲ期非小细胞肺癌随机分为常规分割照射组 (常规组 )和后程加速超分割照射组 (后加速组 )。常规组采用常规分割照射 ,总剂量 6 8～ 72Gy/ 34～ 36次 ,共 7～ 7 5周。后加速组先用常规分割照射 40Gy ,后改用加速超分割照射 (1 5Gy/次 ,2次 /日 ) ,总剂量 70Gy/ 40次 / 6～ 6 5周。用 χ2 比较两组病人的有效率和急性放射反应。结果 :3例病人因放疗期间出现远处转移而退出研究。放疗后 2个月 ,常规组病人CR 6例 (18 2 % ) ,PR 16例 (48 5 % ) ,有效率为 6 6 7% ;而后加速组CR 10例 (2 9 4% ) ,PR 2 0例(5 8 8% ) ,有效率为 88 2 % ,两组有效率比较有显著差异 (P <0 0 5 )。两组Ⅱ度急性放射性气管炎和食道炎的发生率无显著差异。结论 :后程加速超分割放疗能提高不能手术Ⅲ期非小细胞肺癌的近期疗效 ,急性放射反应可以耐受
PURPOSE: To evaluate the efficacy of late-course accelerated hyperfractionation radiotherapy in patients with unresectable stage Ⅲ non-small cell lung cancer. Methods: From August 1996 to February 1999, 70 patients with unresectable stage Ⅲ non-small cell lung cancer diagnosed by histopathology or cytology were randomly divided into routine split radiation group (routine group) and accelerated hyperfractionation Irradiation group (post-acceleration group). Conventional group using conventional split irradiation, the total dose of 68 ~ 72Gy / 34 ~ 36 times, a total of 7 ~ 75 weeks. The post-acceleration group was irradiated with 40Gy of conventional fractionation at first, and then switched to accelerated hyperfractionated irradiation (15Gy / time, 2 times / day) for a total dose of 70Gy / 40 times / 6 ~ 65 weeks. Compare the two groups of patients with χ2 efficiency and acute radiation response. Results: Three patients withdrew from the study because of distant metastases during radiotherapy. At 2 months after radiotherapy, the CR rate was 6 6 7% in CR 6 patients (18 2%) and PR 16 patients (48 5%) in CR group 0 cases (58.8%), the effective rate was 88.2%, there was significant difference between the two groups (P <0 05). There was no significant difference in the incidence of grade II acute radiation tracheitis and esophagitis between the two groups. Conclusion: Late-course accelerated hyperfraction radiotherapy can improve the short-term curative effect of unresectable stage Ⅲ non-small cell lung cancer. Acute radiation reaction can be tolerated