Objective To evaluate the therapeutic effect of body gamma knife surgery combined chemotherapy in the treatment for locally advanced 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: Body - gamma knife combined with chemotherapy.Body - gamma knife with schema - pe - riphery dose 350cGy ～ 400cGy per fraction (50％ dose line), 14 fractions was carried out, at a total dose of 49Gy ～ 56Gy.Chemotherapy with TP regimen 4 cycles was performed one week after the body - gamma knife radiotherapy.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 of the Treatment Group is 65.28％,47.22％ ,and the Control Group' s is 63.16％ , 39.47％, 23.68％, radiation pneumonitis incidence is 3.57％ and 16.67％,respectively.Conclusion Body - gamma knife combined with chemotherapy may have short - term therapeutic effects for the inoperable or refused surgery local advanced non - small cell lung cancer with mild toxicity.%目的 观察体部伽玛刀联合化疗治疗不能手术或拒绝手术的局部晚期非小细胞肺癌(Non-small Cell Lung Cancer,NSCLC)的疗效和副反应.方法 将2006年8月到2009年2月本院治疗的110例符合入选条件的局部晚期NSCLC患者,随机分成治疗组和对照组.治疗组:体部伽玛刀加化疗.体部伽玛刀治疗:单次处方剂量50%等剂量曲线为350cGy～400cGy,1次/d,共14次,总剂量49Gy～56Gy.化疗:采用紫杉醇+顺铂方案,于伽玛刀治疗后1周左右开始,共4个周期.对照组:常规放射治疗加化疗.采用60Co体外照射,放射剂量为50Gy～54Gy,180cGy～200cGy/次,5次/周,5～6周完成.化疗方案同治疗组.结果 治疗组:有效率为81.94%,1年、2年生存率分别为65.28%、47.22%,放射性肺炎发生率3.57%.对照组:有效率为63.16%,1年、2年生存率分别为39.47%、23.68%,放射性肺炎发生率16.67%.差异有统计学意义.结论 体部伽玛刀联合化疗对不能手术或拒绝手术的局部晚期NSCLC有效,毒副作用轻微.
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