立体定向体部放射治疗联合射频热疗治疗非小细胞肺癌的近期疗效观察

摘要

Objective:To study the efficacy and adverse reaction of stereotactic body radiotherapy combined with radiofrequency hyperthermia in the treatment of non -small cell lung cancer.Methods:All 21 cases were treated by stereotactic radiotherapy high segmentation.Tumor diameter <3cm,70% ~80% isodose line covering the target are-a,a single peripheral dose of 7 ~9Gy,the total dose of 36 ~42Gy,5 ~6 times.Tumor diameter of 3 ~5cm,60% ~70% isodose line covering the target area,a single peripheral dose of 5 ~8Gy,total dose 40Gy,5 ~8 times.Tumor di-ameter >5cm,50% ~60% isodose line covering the target area,a single peripheral dose of 4 ~6Gy,the total dose of 40 ~42Gy,7 ~10 times a day,more than 2 weeks.Radiofrequency thermotherapy synchronization treatment,imple-mented in the radiotherapy before or after 45min,time 60min,weekly 1 ~2 times.Time interval was more than 72h,a total of 6 ~8 times.Results:After treatment for 2 ~3 months,all patients were followed up,the complete remission rate was 19.0%(4 /21),response rate was 71.4%(15 /21),the total effective rate was 90.5%(19 /21).Bone mar-row suppression was the main complication,the incidence rate was 61.9%(13 /21).Conclusion:Stereotactic body ra-diotherapy combined with radiofrequency hyperthermia in the treatment of non -small cell lung cancer was effective with mild side effects.%目的：观察立体定向体部放射治疗联合射频热疗治疗非小细胞肺癌的近期疗效和毒副反应。方法：21例患者均采用少分次、大分割的立体定向放射治疗。肿瘤直径＜3cm 者，70％～80％等剂量线覆盖靶区，单次周边剂量7～9Gy，总剂量36～42Gy，分5～6次；肿瘤直径3～5cm 者，60％～70％等剂量线覆盖靶区，单次周边剂量5～8Gy，总剂量40Gy，分5～8次；肿瘤直径＞5cm 者，50％～60％等剂量线覆盖靶区，单次周边剂量4～6Gy，总剂量40～42Gy，分7～10次。隔日治疗，总时间不超过2周。疗程中同步行射频热疗，在放疗前或后45min 内实施，时间为60min，每周1～2次，次间间隔72h 以上，共6～8次。结果：治疗后2～3个月所有患者得到随访。其中完全缓解率为19．0％（4／21），部分缓解率为71．4％（15／21），总有效率为90．5％（19／21）。骨髓抑制为主要并发症，发生率为61．9％（13／21）。结论：立体定向体部放射治疗联合射频热疗治疗非小细胞肺癌近期疗效好，毒副反应轻可耐受，值得临床推广。