目的 评价体部立体定向放射治疗联合化疗治疗不能手术或拒绝手术的局部晚期(WHO分期ⅢA、ⅢB)非小细胞肺癌的疗效和不良反应.方法 将2006年8月～ 2009年2月期间,我院治疗的110例符合入选条件的局部晚期非小细胞肺癌患者随机分成治疗组和对照组.治疗组:体部立体定向放射治疗联合化疗.体部立体定向放射治疗:单次处方剂量50％等剂量曲线为350cGy～400cGy,1/d次,共12～14次,总剂量49Gy～56Gy.化疗:采用紫杉醇+顺铂方案,于体部立体定向放射治疗治疗后1周左右开始,平均4个周期.对照组:常规放射治疗联合化疗.采用60Co体外照射,放射剂量为50Gy～54Gy,180cGy ～200cGy/次,每周5次,5～6周完成.化疗方案同治疗组.结果 治疗组有效率、1年、2年生存率和放射性肺炎发生率分别为81.94％、65.28％、47.22％、3.57％.对照组:有效率、1年、2年生存率和放射性肺炎发生率分别为63.16％、39.47％、23.68％、16.67％.结论 体部立体定向放射治疗联合化疗对不能手术或拒绝手术的局部晚期NSCLC有效,不良反应轻微.%Objective This study evaluated the efficacy and side effects of stereotactic body radiation therapy (SBRT) combined with chemotherapy in the treatment for inoperable or refused surgery locally advanced ( World Health Organization stage Ⅲ A、ⅢB) non-small cell lung cancer patients. Methods From August 2006 to February 2009,110 patients with locally advanced non-small cell lung cancer were randomly divided into Treatment Group and Control Group in this study. Treatment Group: SBRT combined with chemotherapy. SBRT with schema-periphery dose 350cGy ～400cGy per fraction (50% dose line) ,12 ～ 14 fractions was carried out, at a total dose of 49Gy ～ 56Gy. Chemotherapy with TP regimen 4 cycles was performed one week after SBRT. Control Group: Conventional radiotherapy combined with chemotherapy, dose 180cGy ～ 200cGy per fraction, 25 fractions was carried out, at a total dose of 50Gy ～54Gy. Chemotherapy with the same as Treatment Group' s. Results Effective rate, 1-year survival and 2-year survival, radiation pneumonitis incidence of the Treatment Group is 81.94%, 65. 28% , 47. 22% , 3. 57% ,and the Control Group' s is 63.16% , 39. 47% , 23. 68% , 16. 67% , respectively. Conclusion SBRT combined with chemotherapy may have short-term efficacy for the inoperable or refused surgery local advanced non-small cell lung cancer with mild toxicity.
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