论文部分内容阅读
目的总结射波刀立体定向放射治疗对早期周围型非小细胞肺癌的近期疗效。方法回顾性分析中国人民解放军总医院2012年1月-2014年11月收治的40例早期(T1/T2N0M0)周围型非小细胞肺癌患者的病例资料,其中男性31例,女性9例,中位年龄74.5(43~90)岁,以总生存率(overall survival,OS)和无进展生存率(progress-free survival,PFS)为主要观察指标,以客观缓解率(objective response rate,ORR)、疾病控制率(disease control rate,DCR)、无局部失败生存率(local failure-free survival,LFFS)、无区域失败生存率(regional failure-free survival,RFFS)和无远处转移生存率(distant metastasisfree survival,DMFS)为次要观察指标,同时观察失败模式及不良反应。结果中位随访28.5(7~44)个月,2例失访,16例CR(42.1%),7例PR(18.4%),8例SD(21.1%),7例PD(18.4%)。肿瘤ORR为60.5%,DCR为81.6%。1年和3年OS分别为89.7%和83.3%,T1组的1年和3年OS均为100%,T2组的1年和3年OS分别为68.8%和45.8%,两组OS有统计学差异(P=0.000)。1年和3年PFS分别为88.6%和78.2%,1年和3年LFFS分别为97.0%和89.5%,1年和3年DMFS分别为91.5%和87.9%。12例(31.6%)发生Ⅰ度放射性肺炎,4例(10.5%)发生Ⅱ度放射性肺炎,8例(21.1%)发生Ⅰ度疲乏,无Ⅲ级及以上的不良反应。结论射波刀立体定向放射治疗对早期非小细胞肺癌具有较高的局部控制率、总生存率且无远处转移率,不良反应较轻,可作为早期非小细胞肺癌根治性治疗选择之一。
Objective To summarize the short-term curative effect of radiosurgery with stereotactic radiotherapy on early peripheral non-small cell lung cancer. Methods The data of 40 cases of peripheral T1 non-small cell lung cancer (T1 / T2N0M0) from January 2012 to November 2014 in the People’s Liberation Army General Hospital were retrospectively analyzed. There were 31 males and 9 females, the median (74-90) years old. The overall survival rate (OS) and progression-free survival (PFS) were used as the main observation indicators. The objective response rate (ORR) The control rate (DCR), local failure-free survival (LFFS), regional failure-free survival (RFFS) and distant metastasis survival , DMFS) as secondary observation indicators, at the same time to observe the failure mode and adverse reactions. Results The median follow-up was 28.5 months (range, 7 to 44 months). Two patients were lost to follow-up. There were 16 cases of CR (42.1%), 7 cases of PR (18.4%), 8 cases of SD (21.1%) and 7 cases of PD (18.4%). The tumor ORR was 60.5% and the DCR was 81.6%. The 1-year and 3-year OS were 89.7% and 83.3% respectively. The 1-year and 3-year OS were 100% in the T1 group and 68.8% and 45.8% in the T2 group, respectively Learning difference (P = 0.000). The 1-year and 3-year PFS were 88.6% and 78.2%, respectively. The 1-year and 3-year LFFS were 97.0% and 89.5%, respectively. The 1-year and 3-year DMFS were 91.5% and 87.9%, respectively. There were 12 cases (31.6%) of I degree radiation pneumonitis, 4 cases (10.5%) of Ⅱ degree radiation pneumonitis, and 8 cases (21.1%) of I degree fatigue, with no grade Ⅲ and above adverse reactions. Conclusion Radiotherapy knife stereotactic radiotherapy has the advantages of high local control rate, total survival rate, no distant metastasis rate and mild adverse reactions in early stage of non-small cell lung cancer, which can be used as a radical treatment option for early non-small cell lung cancer .