TP方案联合三维适形放疗或调强放疗对Ⅳ期非小细胞肺癌的近期疗效比较

Comparative of the Short-Term Effect of TP Regimen Combined with Three Dimensional Conformal Radiotherapy or Intensity Modulated Radiation Therapy for Stage 1V Non-Small Cell Lung Cancer

目的探讨TP方案联合三维适形放疗或调强放疗对Ⅳ期非小细胞肺癌的近期疗效。方法选取53例Ⅳ期非小细胞肺癌患者，分为观察组（n=30）和对照组（n=23）。对照组采用TP方案联合三维适形放疗，观察组采用TP方案联合调强放疗。比较两组近期疗效、并发症及剂量学差异。结果对照组和观察组治疗有效率分别为73．9％和73．3％，两组比较差异无统计学意义（P〉0．05）。观察组放射性肺炎及放射性食管炎发生率均低于对照组（33．3％，16．7％vs52．2％，34．8％），但两组比较差异无统计学意义（P〉0．05）。两组患者PTV-Dmean、PTV-Dmin、PTV-Dmax等剂量分布参数比较差异无统计学意义（P〉0．05）；观察组cI显著低于对照组，而其HI则显著高于对照组，两组比较差异具有统计学意义（P〈0．05）。观察组MLD、V10、V20、V30等参数均显著低于对照组，其v5显著高于对照组，两组比较差异具有统计学意义（P〈0．05）。结论TP方案联合三维适形放疗或调强放疗对Ⅳ期非小细胞肺癌的近期疗效相近，但调强放疗剂量分布更合理，放疗后并发症更少。

Objective To evaluate the short-term conformal radiotherapy or intensity modulated radiation 53 patients of stage IV non-small cell lung cancer were effect of TP regimen combined with three dimensional therapy for stage Ⅳ non-small cell lung cancer. Methods divided into control group （n=23） and observation group （n=30）. TP regimen combined with intensity modulated radiation therapy were used in observation group and TP regimen combined with three dimensional conformal radiotherapy therapy were used in control group. The clinical efficacy, recurrence rate, T lymphocyte subsets and cytokines of blood serum were compared between the two groups. Results The clinical efficacy was 73.3% in observation group, and was 73.9% in control group, which had no significant difference between the two groups （P 〉 0.05）. The incidence of radioactive pneumonia and radioactive esophagitis in observation group were lower than the control group （33.3%, 16.7% vs 52.2%, 34.8%）. There were no statistically significant difference between two groups in PTV-Dmean, PTV-Dmin and PTV- Dmax. CI in observation group was significantly lower than the control group, and its HI was significantly higher than the control group, with statistical difference （P〈0.05）. The MLD, V10, V20 and V30 in observation group were significantly lower than the control group, and its V5 was significantly higher than the control group, with statistical difference （P 〈 0.05）. Conclusion The short-term effect of TP regimen combined with three dimensional conformal radiotherapy or intensity modulated radiation therapy for stage 1V non-small cell lung cancer is similar, but the dose distribution of intensity modulated radiation therapy is more reasonable with less complication.