图像引导放射治疗在Ⅲ期非小细胞肺癌中的应用

Application of image-guided radiotherapy in Ⅲ stage non-small cell lung cancer

目的比较图像引导放疗(IGRT)与调强放疗(IMRT)两种治疗方式患者的近期疗效和放射性毒性反应,探讨预后影响因素。方法收集52例IGRT的非小细胞肺癌(NSCLC)患者及55例IMRT的NSCLC患者,在满足靶区处方剂量要求的情况下,比较两种治疗方式的近期疗效、放射性毒性反应及影响预后的因素。结果两组治疗后总有效率、控制率差异无统计学意义(P>0.05),IGRT组较IMRT组急性放射性肺炎的发生率低(P<0.05),急性放射性食管炎发生率两组差异无统计学意义(P>0.05)。IGRT 1.0、1.5、2.0年生存率分别为57.7%、35.0%、27.3%,IMRT组分别为50.9%、34.1%、21.8%。两组的中位生存时间分别17.0个月和13.0个月,差异无统计学意义(P>0.05)。结论在NSCLC治疗中,IGRT较LMRT能减轻急性放疗毒性反应的发生,但两种治疗方式对近期疗效的影响差别不明显。

Objective To compare image-guided radiotherapy（IGRT） and intensity-modulated radiotherapy（IMRT） treatment in patients with recent efficacy and toxicity of radioactive reaction ,discuss factors affecting prognosis .Methods Collection of 52 cases of IGRT and 55 cases of IMRT patients with non-small-cell lung cancer（NSCLC） ,satisfy the requirement of target prescription dose in the case ,the recent efficacy of tumor ,comparing two treatments in patients with radioactive toxic effects and factors affect-ing the prognosis .Results The incidence of radioactive pneumonia in IGRT group was lower than the IMRT group （P〈0 .05） ,the incidence of radiation esophagitis had no statistical differences in the two groups （P〉0 .05） .The survival rates of IGRT group 1 , 1 .5 ,2 years after radiotherapy were 57 .7% ,35 .0% ,27 .3% ,IMRT group were 50 .9% ,34 .1% ,21 .8% .The median survival time of IGRT group and IMRT group was 17 months and 13 months respectively ,there was no statistically significant difference（P〉0 .05） .Conclusion In NSCLC treatment ,compared with IMRT ,TGRT could reduce the toxic reaction of radiotherapy ,but the effect of two kinds of treatment for the recent difference is not obvious .