三维适形调强放疗与三维适形放疗同步化疗对Ⅲ期非小细胞肺癌的疗效比较

Three Dimensional Conformal Intensity Modulated Radiotherapy and Three Dimensional Conformal Radiotherapy Concurrent Chemotherapy for Stage Ⅲ Non-small Cell Lung Cancer

目的研究Ⅲ期非小细胞肺癌采用三维适形调强放疗与三维适形放疗同步化疗治疗的临床疗效及毒副作用。方法将50例Ⅲ期非小细胞肺癌患者随机分为观察组和对照组,各25例,观察组接受三维适形调强放疗同步化疗治疗,对照组患者接受三维适形放疗同步化疗治疗,比较两组患者的临床疗效、毒副反应、血清肿瘤标志物含量。结果观察组有效率（60.00%）与对照组有效率（48.00%）比较,差异无统计学意义（χ^2=0.725,P〉0.05）;不良反应：观察组放射性食管炎、放射线肺炎、消化道反应、白细胞减少、血小板减少发生率均明显低于对照组（χ^2=3.974～4.667,P〈0.05）;血清肿瘤标志物：观察组患者血清中角蛋白19片段抗原21-1（CYFRA21-1）、鳞状细胞癌抗原（SCC）、肿瘤特异性生长因子（TSGF）含量明显低于对照组（t=17.501～24.094,P〈0.05）。结论三维适形放疗同步化疗治疗有助于减轻不良反应,降低血清肿瘤标志物含量,提高治疗效果。

Objective To study the efficacy and toxicities of three dimensional conformal intensity modulated radiation therapy and three dimensional conformal radiotherapy concurrent chemotherapy for stage III non-small cell lung cancer. Methods50 patients with stage Ⅲ non-small cell lung cancer were randomly divided into the observation group and the control group,25 cases in each. The observation group received three-dimensional conformal radiotherapy with concurrent chemotherapy. The control group patients received three-dimensional conformal radiotherapy combined with chemotherapy,clinical curative effecst,adverse reactions and serum tumor marker content were compared. Results Efficiency between the observation group（ 60. 00%） and the control group（ 48. 00%） had no significant difference（ χ^2= 0. 725,P〈0. 05）; adverse reactions： radiation esophagitis,radiation pneumonia,gastrointestinal reactions,leukocyte reduction and thrombocytopenia occurrence rate of the observation group were significantly lower than those of the control group（ χ^2= 3. 974 ～ 4. 667,P〈0. 05）; serum tumor markers： the level of serum cytokeratin 19 fragment antigen 21-1（ CYFRA21-1）,squamous cell carcinoma antigen（ SCC） and tumor specific growth factor（ TSGF）content of the observation group were significantly lower than those of the control group（ t = 17. 501 ～ 24. 094,P〈0. 05）. Conclusion Three dimensional conformal radiotherapy combined with concurrent chemotherapy can reduce adverse reactions,decrease the content of serum tumor marker,and improve therapeutic effects.