目的: 观察三维适形放疗( 3D－CRT) 后程联合恩度治疗老年晚期非小细胞肺癌( NSCLC) 的近期疗
效和治疗副反应。方法: 将我科收治的60 例老年局部晚期NSCLC 病人随机分为两组，后程组( 30 例) : 采用3DCRT
后程联合恩度治疗，从适形放疗PTV 剂量达到40Gy 开始，直至放疗结束，每次放疗前30min 给予恩度15mg
静脉滴注; 单纯组( 30 例) : 采用单独3D－CRT．以WHO 的RECIST 标准进行疗效评价，分别比较治疗结束后3mo
的治疗有效率和毒副反应及1a 时的治疗有效率。结果: 后程组和单纯组治疗后3mo 的临床受益率( CR+PR+
SD) 分别为96．7%和86．7%，P= 0．350; 总有效率( CR+PR) 分别为73．3%和60．0%，P = 0．412; 两组的1a 临床受益率
分别为86．7%和73．3%，P= 0．333; 两组常见的毒副反应相近，P＞0．05，两组间比较差异均无统计学意义; 两组1a
的总有效率，后程组为83．3%优于单纯放疗组的56．7%，P = 0．047，差异有统计学意义。结论: 恩度联合3D－CＲT
治疗局部晚期非小细胞肺癌与单纯3D－CRT 治疗比较，提高了1a 总有效率，两组毒副反应相近，后程组未增加
治疗相关副反应。

Objective: To observe the effects of three－dimensional conformal radiotherapy ( 3DCRT)
later－course combined with Endostar in the treatment of elderly patients with advanced non small
cell lung cancer( NSCLC) the recent therapeutic effect and side reaction．Methods: 60cases of elderly
patients with locally advanced NSCLC patients in our hospital，were randomly divided into two groups，
the later － group ( 30cases) : treated with Endostar combined with 3D － CRT late course， from the
conformal radiotherapy PTV dose to 40 Gy began，until the end of radiotherapy， radiation every time before
30 min 15 mg intravenous infusion of Endostar; 3D－CRT group( 30cases) : the use of 3D－CRT alone．
Efficacy evaluation was performed with RECIST’s WHO standard，and the efficacy and toxicity of
3months after the end of treatment were compared with that of 12months．Results: Late course group and
3D－CRT group after 3months of clinical benefit rate ( Cr + PR+ SD) were 96．7%and 86．7%，P =
0．350．The total response rate ( Cr + PR) were 73．3%and 60．0%，P = 0．412; Two groups of 1 year
clinical benefit rate was 86．7% and 73．3%，P = 0．333; similar common adverse reaction of two groups，
P＞0．05，differences had no statistical significance between the two groups; two groups of 1 year total efficiency，
course group was 83．3%better than simple radiotherapy group 56．7%，P = 0．047， the difference
is statistically significant．Conclusion: Endostar combined with 3D－CRT treatment of locally advanced
non small cell lung cancer with 3D－CRT treatment to improve the total efficiency of 1 year， the toxic
and side effects of the two groups are similar，Later－course group did not increase treatment－related adverse
events．

R734．2

 收稿日期: 2016－08－12; 修回日期: 2016－10－18
基金项目: 内蒙古自治区科学基金项目( 2013MS111108)
作者简介: 林宇( 1965－) ，男，内蒙古医科大学附属医院主治医师。
通讯作者: 郁志龙，主任医师，E－mail: Ｒichard－yu1961269@ sina．com 内蒙古医科大学附属医院， 010050