本文選題：非小細(xì)胞肺癌 + 放射治療�。� 參考：《北京協(xié)和醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:觀察放療聯(lián)合易瑞沙治療不能手術(shù)且不能行同步放化療的局部晚期非小細(xì)胞肺癌患者的近期療效、生存和安全性。材料與方法:選取不能手術(shù)且不能行同步放化療的局部晚期非小細(xì)胞肺癌患者,在中國醫(yī)學(xué)科學(xué)院腫瘤醫(yī)院放療科接受胸部調(diào)強(qiáng)放療,同期接受易瑞沙250mg每日一次的治療。結(jié)果:從2014年7月至2017年3月,入組30例,可分析29例。放療結(jié)束后1月部分緩解(PR)、穩(wěn)定(SD)和進(jìn)展(PD)分別有21(72.4%)、6(20.7%)和2(6.9%)例,治療反應(yīng)率(CR+PR+SD)為93.1%,客觀有效率(CR+PR)為72.4%。放療結(jié)束后3月PR、SD和PD分別有15(53.6%)、6(21.4%)和7(25%)例,治療反應(yīng)率為75%,客觀有效率為53.6%(因1例患者治療結(jié)束未達(dá)3個月,共28例參與放療結(jié)束后3月療效評價)。隨訪截止日期2017年5月15日,中位隨訪18個月,死亡8例(27.6%),存活21例(72.4%);20例(68.9%)患者出現(xiàn)疾病進(jìn)展,其中局部進(jìn)展16例(55.2%),遠(yuǎn)處轉(zhuǎn)移8例(27.6%)。全組的MST未達(dá)到,中位PFS 11個月,1年OS和PFS分別為83.9%和44.5%,2年OS和PFS分別為66.7%和21.4%。單因素分析顯示分期、原發(fā)灶直徑和PTV的體積對PFS有意義(p0.001,95%CI:3.12-57.17;p=0.025,95%CI:9.70-12.38;p =0.036,95%CI:9.70-12.38),多因素分析顯示分期和PTV體積為PFS的獨(dú)立預(yù)后因素(p=0.001,95%CI:-13.63--1.78;p=0.001,95%CI:1.16-12.61)。ⅢB 期 OS 和 PFS 均優(yōu)于ⅢA 期。全組未觀察到4級急性不良反應(yīng),3級急性不良反應(yīng)共2例(6.9%),2級急性放射性肺炎7例(24.1%),未觀察到3級急性放射性肺炎。結(jié)論:對于不能手術(shù)且不能行同步放化療的局部晚期非小細(xì)胞肺癌,放療聯(lián)合易瑞沙的治療,近期療效尚可,患者耐受良好,遠(yuǎn)期療效有待進(jìn)一步觀察。
[Abstract]:Objective: to observe the short-term efficacy, survival and safety of radiotherapy combined with Irelisha in the treatment of locally advanced non-small cell lung cancer (NSCLC). Materials and methods: patients with locally advanced non-small cell lung cancer (NSCLC) who could not be operated on and who could not be treated with concurrent radiotherapy were treated with intensity-modulated chest radiotherapy (IMRT) in the department of radiotherapy of Cancer Hospital of the Chinese Academy of Medical Sciences (CAS). The patients were treated with 250mg once a day at the same time. Results: from July 2014 to March 2017, there were 30 cases in the group and 29 cases were analyzed. There were 21 (72.4%) cases of partial remission (PR), 6 (20.7%) of stable (SD) and 2 (6.9%) of progression (PD) at one month after radiotherapy. The therapeutic response rate (CR PR SD) was 93.1%, and the objective effective rate (CR PR) was 72.4%. There were 15 (53.6%) cases of PRSD and 7 (25%) cases of PD at 3 months after radiotherapy. The response rate was 75 and the objective effective rate was 53.6%. The median follow-up date was May 15, 2017. The median follow-up period was 18 months, 8 patients died (27.6%), 21 patients survived (72.4%), 20 patients (68.9%) had disease progression, 16 patients had local progression (55.2%), 8 patients had distant metastasis (27.6%). The MST of the whole group was not reached, the median PFS was 83.9% and 44.5% in 11 months, OS and PFS in 1 year, and 66.7% and 21.4% in 2 years, respectively. Univariate analysis showed that staging, diameter of primary focus and volume of PTV were significant to PFS (p0.00195 CI: 3.12-57.17). Stage 鈪，

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