局限期小细胞肺癌放疗靶区前瞻性随机对照研究的初步报告

被引：4

作者：

胡晓 ^{[1
]}

包勇 ^{[1
]}

张力 ^{[2
]}

陈媛媛 ^{[1
]}

李凯新 ^{[1
]}

王卫华 ^{[1
]}

刘源 ^{[1
]}

何瀚 ^{[1
]}

孙宗文 ^{[1
]}

庄婷婷 ^{[1
]}

王彦 ^{[1
]}

陈静 ^{[1
]}

梁颖 ^{[2
]}

张阳 ^{[2
]}

赵洪云 ^{[2
]}

王凤华 ^{[2
]}

陈明 ^{[1
]}

机构：

[1] 华南肿瘤学国家重点实验室,中山大学肿瘤防治中心放疗科

[2] 中山大学肿瘤防治中心内科

来源：

中国肺癌杂志 | 2010年 / 13卷 / 07期

关键词：

肺肿瘤; 小细胞肺癌; 局限期; 放疗靶区;

D O I：

暂无

中图分类号：

R734.2 [肺肿瘤];

学科分类号：

100214 ;

摘要：

背景与目的在局限期小细胞肺癌(limited-stage small cell lung cancer,LSCLC)的放化疗综合治疗中,放疗靶区等方面尚存争议。本研究旨在前瞻性比较LSCLC经诱导化疗后按不同靶区范围进行放疗的局部控制率和毒副反应的差异及对生存的影响。方法LSCLC患者,经EP方案诱导化疗2周期后,随机分为研究组和对照组,分别按照化疗后和化疗前原发灶范围勾画放疗靶区(gross tumor volume-tumor,GTV-T),区域淋巴结靶区(gross tumor volume-nodal,CTV-N)两组均包括达到诊断标准的淋巴结所在的结区。放疗45Gy/30次/19天,开始于化疗后1周-2周,放疗中按期进行第3周期化疗。放疗后再行3周期化疗。完全缓解者行预防性全脑照射(prophylactic cranial irra-diation,PCI)。结果研究组与对照组分别入组37例、40例患者。局部复发率分别为32.4%、28.2%(P=0.80),其中单独照射野外复发率分别为3.0%、2.6%(P=0.91),且均位于原发病灶同侧锁骨上区。纵隔型N3是照射野外复发危险因素(P=0.02,OR=14.13,95%CI:1.47-136.13);放疗期间发生I度、II度体重减轻分别为29.4%、5.9%和56.4%、7.7%(P=0.04);0度-I度和II度-III度后期放射性肺损伤发生率分别为97.1%、2.9%和84.6%、15.4%(P=0.07)。研究组和对照组中位生存时间分别为22.1个月和26.9个月;1、2、3年总生存率分别为77.9%、44.4%、37.3%及75.8%、56.3%、41.7%(P=0.79)。结论本研究结果显示仅照射化疗后原发灶范围及阳性淋巴结区未降低局部控制率和总生存率,而放疗毒性降低。但目前样本量尚未达到设计要求,最终结论需继续扩大样本数后得出。

引用

页码：691 / 699

页数：9

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