三维适形放疗联合高流量氧疗在老年晚期肺癌化疗患者中的应用效果

Application effect of three-dimensional conformal radiotherapy combined with high flow oxygen therapy in chemotherapy of advanced elderly lung cancer patients

目的探讨三维适形放疗联合高流量氧疗在老年晚期肺癌重症化疗患者中的应用效果。方法依据治疗方式的不同将109例老年晚期肺癌患者分为常规组(n=54)和联合组(n=55),常规组患者给予紫杉醇+顺铂化疗,联合组患者在常规组的基础上给予三维适形放疗联合高流量氧疗。比较两组患者的血气分析指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、氧合指数]、肿瘤标志物[癌胚抗原(CEA)、糖类抗原125(CA125)]、炎性因子[肺表面活性物质相关蛋白A(SP-A)、细胞间黏附分子-1(ICAM-1)]、氧化应激指标[丙二醛、超氧化物歧化酶(SOD)]及不良反应发生情况。结果治疗后,两组患者PaO_(2)、氧合指数、ICAM-1、SP-A、丙二醛水平均高于本组治疗前,PaCO_(2)、CEA、CA125、SOD水平均低于本组治疗前,联合组患者PaO_(2)、氧合指数、SOD水平均高于常规组,PaCO_(2)、CEA、CA125、ICAM-1、SP-A、丙二醛水平均低于常规组,差异均有统计学意义(P﹤0.05)。联合组患者的不良反应总发生率为3.64%,低于常规组患者的14.81%,差异有统计学意义(P﹤0.05)。结论三维适形放疗联合高流量氧疗用于老年晚期肺癌重症化疗患者中,可改善患者的呼吸能力,降低肿瘤标志物水平,改善氧化应激损伤。

Objective To explore the application effect of three-dimensional conformal radiotherapy combined with high flow oxygen therapy in chemotherapy of advanced elderly lung cancer patients.Method A total of 109 patients with advanced lung cancer were selected and divided into conventional group(n=54,treated with paclitaxel+cisplatin chemotherapy)and combined group(n=55,treated with three-dimensional conformal radiotherapy+high flow oxygen therapy on the basis of conventional group)according to the different treatment methods.Blood gas analysis indexes[arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))and oxygenation index],tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125)],inflammatory factors[surfactant protein A(SP-A),intercelluar adhesion molecule-1(ICAM-1)],oxidative stress index[malondialdehyde and superoxide dismutase(SOD)]and adverse reactions were compared between the two groups.Result After treatment,the levels of PaO_(2),oxygenation index,ICAM-1,SP-A,and malondialdehyde in both groups were higher than those before the treatment,the levels of PaCO_(2),CEA,CA125,and SOD were lower than those before the treatment,the levels of PaO_(2),oxygenation index,and SOD in the combination group were higher than those in the conventional group,the levels of PaCO_(2),CEA,CA125,ICAM-1,SP-A,and malondialdehyde in the conventional group were lower than those of the conventional group,the differences were statistically significant(P<0.05).The total incidence of adverse reactions in the combined group was 3.64%,lower than 14.81% in the conventional group,the difference was statistically significant(P<0.05).Conclusion The combination of three-dimensional conformal radiotherapy and high flow oxygen therapy can improve the respiratory ability,reduce tumor marker levels,and improve oxidative stress damage in advanced elderly patients with severe lung cancer undergoing chemotherapy.