目的:探讨三维适形放射治疗(3-dementional conformal radiation therapy,3D-CRT)在Ⅳ期非小细胞肺癌中的临床应用,为晚期非小细胞肺癌患者,特别是老年、伴有内科疾病及一般状况差的病人提供安全、有效的治疗方法.方法:回顾性分析我院2007年12月-2010年12月258例初诊经组织学或细胞学证实的Ⅳ期非小细胞肺癌患者.根据治疗方式不同分三组:单纯放疗组、单纯化疗组、放化联合组进行对照.结果:单纯放疗组、单纯化疗组、放化联合组中位生存时间分别为9个月、11个月和13个月;0.5年生存率为75.8％、71.8％和85.1％;1年生存率为29.8％、40.5％和56.4％;2年生存率为9.1％、12.3％和14.5％;近期有效率分别为57.6％、42.0％、64.9％;进展率分别为48.5％、49.6％、40.4％;中位无进展时间分别为6个月、7个月、9个月.放疗与化疗结合并未增加化疗的毒副反应(P＞0.05).结论:3D-CRT联合化疗应用于Ⅳ期非小细胞肺癌,较单纯化疗和单纯放疗提高了中位生存期和0.5年、1年、2年生存率,而并未增加毒副反应;对老龄、合并内科疾病、一般状况差的病人单纯精确放疗也取得了比较理想的效果.%Objective:To evaluate the clinical effect of patients with stage Ⅳ non-small cell lung cancer (NSCLC)treated with three dimensional conformal radiation therapy(3D-CRT).Methods:From 2004 to 2007,258 patients with stage Ⅳ NSCLC confirmed pathologically treated with radiotherapy,chemotherapy and chemoradiotherapy were restrospectively analyed.Results:The median survival time was 9 months in group 1,11 months in group 2 and 13 months in group 3.The half-year,1 and 2 year survival rates were 75.8％,29.8％ and 9.1％ in group 1,71.8％,40.5％ and 12.3％ in group 2 and 85.1％,56.4％ and 14.5％ in group 3.The complete and partial response rate was 57.6％ in group 1,42.0％ in group 2 and 64.9％ in group 3.The progression rate was 48.5％ in group 1,49.6％ in group 2 and 40.4％ in group 3.Median progression-free survival time was 6 months in group 1,7months in group 2,9 months in group.The treatment toxicity were not increased (P ＞ 0.05).Conclusion:The patients with stage Ⅳ non-small cell lung cancer treated with 3D-CRT combined with chemotherapy could improve CR and PR rate,the median survival time and 0.5,1,2 year survival rates.The treatment toxicity was not increased.The patients treated with 3D-CRT simply could get good results,especially for the patients with physical diseases,the elderly and the low general situation.
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