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目的 观察逐步递量加速超分割放射治疗 (EHART)Ⅲb 期非小细胞肺癌 (NSCLC)的近期疗效和急性放射反应。方法 73例Ⅲb 期NSCLC进入EHART组。放射治疗的第 1,2周 ,1.2Gy 2次 /d间隔 6h以上 ,第 3,4,5周分别为 1.3,1.4,1.5Gy 2次 /d ,均 5天 /周。照射野仅包括胸部CT或MRI可见的原发灶和淋巴结转移灶以及周围 1.0～ 1.5cm的正常组织。肿瘤灶总剂量 6 6Gy ,5 0次 ,5周。放射治疗前化疗 1～ 2个疗程 ,放射治疗后继续化疗 ,总共 4～ 6个疗程。鳞癌或大细胞癌用EP方案 ;腺癌或鳞腺癌用MVP方案。结果 73例中 12例未完成预定治疗计划。在按计划完成的 6 1例中 ,治疗后体重下降者占 33% (2 0 / 6 1) ;治疗后KPS下降者占 33% (2 0 / 6 1) ;放射性食管炎(RTOG标准 )占 79% (48/ 6 1) ,其中Ⅲ级占 8% (5 / 6 1) ;放射性肺炎占 39% (2 4/ 6 1) ,其中Ⅲ级占 7%(4/ 6 1) ;锁骨上区皮肤急性反应 (湿性脱皮 )占 7% (4/ 6 1)。原发灶完全缓解 (CR)占 10 % (6 / 6 1) ,部分缓解 (PR)占 6 9% (42 / 6 1) ,无变化 +病变进展 (NR +PD)占 2 1% (13/ 6 1) ,总有效率为 79% ;锁骨上淋巴结CR为 5 7% (2 0 / 35 ) ,PR为 40 % (14/ 35 ) ,NR +PD为 3% (1/ 35 ) ,总有效率为 97%。结论 E HART能为大多数Ⅲb 期NSCLC患者耐受 ,有?
Objective To observe the short-term efficacy and acute radiation response of step-rate accelerated hyper-fractionated radiotherapy (EHART) Ⅲb non-small cell lung cancer (NSCLC). Methods 73 cases of stage Ⅲ b NSCLC entered the EHART group. The first and second week of radiotherapy, 1.2Gy 2 times / d interval more than 6h, 3,4,5 weeks were 1.3,1.4,1.5 Gy 2 times / d, were 5 days / week. The irradiation field only includes the primary tumor and lymph node metastasis visible on the chest CT or MRI and the surrounding normal tissues of 1.0 to 1.5 cm. Total tumor dose 6 6 Gy, 50 times, 5 weeks. Radiotherapy before chemotherapy 1 to 2 courses, radiotherapy continue chemotherapy, a total of 4 to 6 courses. EP regimen for squamous cell carcinoma or large cell carcinoma; MVP regimen for adenocarcinoma or squamous cell carcinoma. Results of 73 cases, 12 cases did not complete the scheduled treatment plan. Among the 61 patients who completed the planned treatment, the weight loss after treatment was 33% (20/61); the decrease of KPS after treatment was 33% (20/61); the percentage of radiation esophagitis (RTOG) 79% (48/61), which accounted for 8% (5/6 1) of grade Ⅲ; radiation pneumonia accounted for 39% (4 of 6 1), of which 7% District skin acute reaction (wet peeling) accounted for 7% (4/6 1). The rate of complete remission (CR) was 10% (6/61), partial remission (PR) was 69% (42/61), no change + disease progression (NR + PD) was 21% / 6 1). The total effective rate was 79%. The supraclavicular lymph node CR was 57% (20/35), PR 40% (14/35), NR + PD 3% (1/35) The effective rate is 97%. Conclusion E HART can tolerate most patients with stage Ⅲ b NSCLC, with?