目的:观察立体定向伽玛射线(体部伽玛刀)治疗中晚期非小细胞肺癌的疗效,探讨体部伽马刀在治疗非小细胞肺癌的临床价值.方法:将96例采用体部伽玛刀治疗Ⅲ-Ⅳ期非小细胞肺癌.治疗剂量3.5 ～4.2Gy/次,每日1次,5次/周,一般治疗10次,平均剂量6 000 ～7 200cGy,最大剂量点8500cGy,随访6～24个月.分别用RECISTl.1评价标准进行近期疗效评价.结果:96例患者1、3、6个月原发肿瘤病灶完全缓解分别为20.83％、26.04％、27.08％;总有效率为78.13％、89.58％、91.67％.1年总生存率为73.96％,2年生存率为60.42％,差异具有统计学意义(P＜0.05).放疗后患者情绪功能、咳嗽和呼吸困难得到明显改善,与放疗前比较,差异有统计学意义(P＜0.05).体部伽玛刀治疗期间的主要不良反应为胃肠道反应、放射性肺损伤、反射性食管炎.结论:体部伽玛刀作为一种有效安全的局部治疗手段,对中晚期非小细胞肺癌具有较好的治疗效果,同时放射毒副反应的发生程度较轻,患者的接受性高,具有有效的提高局部控制率和生存率,且并发症发生率低.%Objective:To observe the curative effect of middle-late stage non-small cell lung cancer treated with the three-dimensional stereotactic gamma rays (body gamma knife),and explore the clinical value of body gamma knife in the treatment Ⅲ-Ⅳ of non-small cell lung cancer.Methods:Treatment dose of 3.5 ～ 4.2Gy/times,1 times a day,five times per week,general treatment 10 times,the average dose of 6 000 ～7 200cGy,maximum dose point 8 500cGy,followed up for 6 ～24 months.With RECIST1.1 evaluation standard for the recent curative effect evaluation.Results:The 1,3 and,6-month year complete response rates were 20.83 ％,26.04％,27.08％,and the overall response rates were 78.13％,89.58％,91.67 ％,respectively.The 1,2-year overall survival rates were 73.96％ and 60.42％,respectively(P ＜ 0.05).The emotional ftnction,cough,difficulty breathing were improved significantly after treatment(P ＜ 0.05).The adverse reactions were gastrointestinal reaction,radioactive lung injury,radioactive esophagitis.Conclusion:Body gamma knife treatment effect for locally advanced non-small cell lung cancer curative is satisfied,and has light radiation side effects,acceptable for middle-late patients.Partial treatment is an effective security,can effectively improve the local control and survival rate,with low complication rates.
展开▼
