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《常规设野与累及野照射局部晚期非小细胞癌的临床研究【临床医学毕业论文范文格式下.doc》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。
1、临床医学论文•常规设野与累及野照射局部晚期非小细胞癌的临床硏究【摘要】〔目的〕探讨局部晚期肺癌的放疗范围。〔方法〕87例局部晚期肺癌随机分为累及野组和常规野组，两组其他特征相似。〔结果〕全组中位生存时间12.00个月；1、2年总生存率分别为58.71%，17.93%,常规野组和累及野组疗效相似，1、2年生存率分别为59.31%,17.85%和57.86%,18・30%・（P>0・05）,中位生存时问分别为12.14月和11.87月。常规野组和累及野组的治疗失败原因为病灶局部、远处转移、区域复发,分别为75.86%'55.17%、3・4
2、5%和70.27%'56.76%、5.40%（P>0.05）。常规野放射性肺炎的发生率I〜U级32.5%,H〜HI级15.00%,累及野组I〜II级27・66%,U〜HI级14.89%.常规野组IV级放射性肺炎2例<结论〕部晚期肺癌给予常规野（预防淋巴结区）和累及野放疗，预后无明显改善，累及野可减轻放射性肺炎程度，建议累及野照射。【关键词】非小细胞肺癌；放射治疗;照射野；区域淋巴结Abstract:〔Objective〕Tostudytheoptionalfieldofradiotherapyforpatientswithlocall
3、yadvancednonsmal1eel1lungcancer(NSCLC)byanalysisofrecurrencepatternswhenelectivelyunphnodeirradiationwasomitted・〔Methods〕87patientswithlocallyadvancedNSCLC,weredividedintotwogroups.(Results]Al1patientscompletedthetreatmentwitharesponserateof80.00%and78.82%inconventional
4、fieldgroupandinvolvedfieldgroup,respectively.I〜U,II〜Hlgradeofpneumoniaobservedinconventioualfieldgroupwas32.5%,20%versus27.66%,14.89%,respectivcly,ininvolvedfieldgroup.TwoofthosepatientsinconventionalfieldgrouphadIVgradepneumonia.Theoveral1survivalrateof1and2yearwas58.7
5、1%and17.93%,respectively,withmediansurvivaltimcof12.00months.The1and2yearsurvivedraleinpatientswithconventionalfieldgroupandinvelvedfieldgvoup.was59.31%,17.85and57.86%,18.30%(P>0.05)withmediansurvivaltimeof12.14onouthsand11.87months,respectivel1y.Thedifferencebetweenthe
6、tworadiotherapywasnosignificant(P>0.05).Infieldrecurences,distantrecurrencesandrcginalrecurrencesdevelopedinconventionalfieldgroup75.86%,55.17%,3.45%,versus70.27%,56.76%,5.40%.[Conclusion]Omittingelectivelymphnodeirradiationdidnotcauseasignificantamountoffailureinlymphn
7、oderegioninvolvedintheclinicaltargetvolune,involvedfieldiradiationdidnotreducethesurviva1.Therefore,wesuggestinvolcdfieldirradiationinpatientswithNSCLC.Keywords:NSCLC；radiotherapy;irradiationfieldsize»electivelymphnoderegion我国原发性肺癌的发病率明显上升,已成为恶性肿瘤的首位死因淇中,非小细胞肺癌(Nonsmall
8、celllungcancer,NSCLC)的发病率占肺癌总数的75%〜80%[1〕。不可手术的中晩、晩期肺癌占了大多数，内约半数为局部广泛期的DIA、MB期，其主要治疗方法为放疗。但对于放疗靶区的大小至今尙没有统一。1资
