胸部精确放疗在Ⅳ期非小细胞肺癌寡转移患者的临床疗效

摘要

目的 探讨胸部精确放疗对Ⅳ期非小细胞肺癌(NSCLC)寡转移患者的临床疗效.方法经病理确诊并完成4个周期含铂方案化疗后达疾病控制的初诊Ⅳ期NSCLC寡转移患者86例,随机均分为两组:化疗组接受观察或继续化疗1～2个疗程;放化组接受胸部累及野照射精确放疗,后观察或继续化疗1～2个疗程.观察临床有效率、疾病控制率及1、2、3年生存率、胸部症状发生情况及放化疗不良反应.结果 化疗组和放化组分别接受继续化疗共56和50个疗程.放化组有效率、疾病控制率及1、2、3年生存率均高于化疗组(P<0.05).放化组咳痰/喘鸣、胸壁疼痛症状低于化疗组(P<0.05).放化疗不良反应多为Ⅰ、Ⅱ级,无放化疗相关死亡病例.结论 对初诊Ⅳ期NSCLC寡转移患者行胸部累及野精确放疗疗效优于单纯化疗,不良反应可耐受.%Objective To investigate clinical value of thoracic precise radiotherapy in the patients with stage Ⅳ non-small cell lung cancer(NSCLC) and pulmonary oligo metastasis.MethodsEighty-six newly diagnosed NSCLC patients with pulmonary oligo metastasis were randomly divided into two groups of A(treated with chemotherapy) and B(treated with sequential thoracic precise radiotherapy).The patients had completed four platinum-based chemotherapy courses and received continuous chemotherapy for 1 or 2 courses.The clinical efficacy,disease control rate,1-,2-,and 3-year survival rate,chest symptoms and radiotherapy and chemotherapy side effects were observed.ResultsThe patients of groyps of A and B received continuous chemotherapy for a total of 56 and 50 courses,respectively.The effectiveness rate,disease contril rate and 1-,2-and 3-year survival rate were higher in group A than those in group B(P<0.05).Group A had adverse effects ofⅠ,Ⅱ grade mostly and no chemotherapy-related death.Conclusion Compared to chemotherapy alone in the treatment of NSCLC patients with pulmonary oligo metastasis,the sequential thoracic precise radiotherapy has better efficacy with tolerable adverse effects.