常规分割与大分割三维适形放射治疗非小细胞肺癌合并上腔静脉压迫综合征

Conventional Segmentation and Large Fractionated Three-dimensional Conformal Radiotherapy in the Treatment of Non Small Cell Lung Cancer with Superior Vena Cava Syndrome

目的探讨大分割与常规分割三维适形放射治疗非小细胞肺癌合并上腔静脉压迫综合征的有效性和安全性,为改善患者预后提供临床参照.方法分析六安市中医院2010年1月至2012年12月收治的63例非小细胞肺癌合并上腔静脉压迫综合征患者的一般资料,根据不同放射分割方式分为观察组(n=28)和对照组(n=35),观察组给予大分割三维适形放射治疗,对照组给予常规分割三维适形放射治疗,比较2组患者的临床疗效、毒副反应及1 a、2 a生存率.结果观察组完全缓解率为96.43%,显著高于对照组的74.29%(P<0.05);观察组治疗2周内完全缓解为89.29%,显著高于对照组的62.86%(P<0.05);观察组总有效率为85.71%,显著高于对照组的62.86%(P<0.05);观察组临床获益率为96.43%,与对照组的91.43%比较,差异无统计学意义(P>0.05);2组患者毒副反应发生情况比较,差异无统计学意义(P>0.05);2组患者1 a、2 a生存率比较,差异均无统计学意义(P>0.05).结论大分割三维适形放射治疗非小细胞肺癌合并上腔静脉压迫综合征的近期疗效优于常规分割治疗,且并未增加毒副反应,值得临床重视.

Objective To explore the efficacy and safety of large and conventional fractionated three dimensional conformal radiation therapy for non small cell lung cancer with superior vena cava compression syndrome,and to provide clinical reference for improving the prognosis of patients with non small cell lung cancer.Methods The general data of 63 patients with non small cell lung cancer complicated with superior vena cava syndrome treated in Lu'an Hospital of Traditional Chinese Medicine from January 2010 to December 2012 were analyzed retrospectively. According to the different treatment methods, the patients were divided into observation group (n =28) and control group (n =35) .The control group was given conventional fractionated three-dimensional conformal radiation therapy,three dimensional conformal radiation therapy was given to the observation group. The clinical efficacy, toxicity, and 1,2 years survival rate of the two groups were compared.Results The complete remission rate of observation group was 96.43%,which was significantly higher than 74.29% in the control group (P <0.05). The complete remission in the observation group was 89.29%in two weeks, which was significantly higher than 62.86% in the control group (P <0.05) . The total effective rate of observation group was 85.71%,which was significantly higher than that 62.86%in the control group ( P<0.05). The clinical benefit rate of observation group was 96.43%,and there was no significant difference between the two groups ( P>0.05).There was no significant difference in the incidence of adverse reactions between the two groups ( P>0.05) . There was no significant difference in 1,2 year survival rate between the two groups ( P>0.05) . Conclusion Three dimensional conformal radiation therapy for non small cell lung cancer patients with superior vena cava syndrome is superior to conventional treatment, and does not increase the toxic side effects, which is worthy of clinical attention.