图像引导大分割调强放疗同步化疗治疗局部晚期非小细胞肺癌患者的疗效分析

Curative effect of image guided large segmental intensity modulated radiotherapy combined with concurrent chemotherapy in patients with locally advanced non-small cell lung cancer

目的探讨图像引导大分割调强放疗同步化疗治疗局部晚期非小细胞肺癌(NSCLC)的疗效。方法根据治疗方法不同将90例局部晚期NSCLC患者分为对照组(n=48)和研究组(n=42),对照组患者行常规分割的三维适形放疗同步化疗治疗,研究组患者行图像引导大分割调强放疗同步化疗治疗。对两组患者的临床疗效、治疗前后血清肿瘤标志物[血管内皮生长因子(VEGF)、癌胚抗原(CEA)]水平、不良反应发生情况及生存情况进行比较。结果研究组患者的治疗总有效率高于对照组(P﹤0.05);治疗前,两组患者的血清VEGF、CEA水平比较,差异均无统计学意义(P﹥0.05);治疗后,两组患者的血清VEGF、CEA水平均低于本组治疗前(P﹤0.05);治疗后,研究组患者的血清VEGF、CEA水平均低于对照组(P﹤0.05)。两组患者的总不良反应发生率比较,差异无统计学意义(P﹥0.05);研究组患者的1年生存率高于对照组(P﹤0.05)。结论图像引导大分割调强放疗同步化疗治疗局部晚期NSCLC患者的临床疗效明确,可以在有效调节患者肿瘤标志物水平的同时提高患者的1年生存率,且未增加药物不良反应。

Objective To investigate the curative effect of image guided large segmental intensity modulated radiotherapy combined with concurrent chemotherapy in patients with locally advanced non-small cell lung cancer (NSCLC). Method 90 patients with locally advanced NSCLC were divided into control group (conventional fractionated three-dimensional conformal radiotherapy combined with concurrent chemotherapy,n=48) and study group (image guided large segmental intensity modulated radiotherapy combined with concurrent chemotherapy,n=42) according to treatment modalities. The clinical curative effect,serum tumor markers [vascular endothelial growth factor (VEGF) and carcinoembryonic antigen (CEA)] before and after treatment,incidence of adverse reactions and survival were compared between the two groups.Result The total response rate of the study group was higher than that of the control group (P<0.05).There was no significant difference in serum VEGF,CEA level between the two groups before treatment (P>0.05).However, the level of serum VEGF and CEA in both groups were significantly decreased after treatment (P<0.05).The level of serum VEGF and CEA in the study group were lower than those in the control group after treatment (P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).The 1-year survival rate of the study group was higher than that of the control group (P<0.05).Conclusion Image guided large segmental intensity modulated radiotherapy combined with concurrent chemotherapy is effective in the treatment of patients with locally advanced NSCLC.It can effectively regulate levels of tumor markers while improving the 1-year survival rate of patients, without increasing adverse drug reactions.