适形调强放疗联合或不联合化疗治疗≥5 cm的非小细胞肺癌的临床疗效及不良反应

Clinical efficacy and side effects of conformal intensity-modulated radiotherapy combined with or without chemotherapy in the treatment of non-small cell lung cancer ≥5 cm

目的观察适形调强放疗联合或不联合化疗治疗≥5cm的非小细胞肺癌的临床疗效及不良反应。方法回顾性分析2015年1月至2017年10月在四川省乐山市人民医院接受适形调强放疗的75例≥5cm非小细胞肺癌患者的临床资料。根据治疗方案的不同,将患者分为对照组和观察组。对照组患者(n=41)给予单独的个体化适形调强放疗,观察组患者(n=34)在接受个体化适形调强放疗基础上联合顺铂为基础的化疗。比较两组患者的临床疗效、不良反应,以及1年生存率。结果观察组患者的临床治疗有效率为73.5%(25/34),高于对照组的65.9%(27/41),组间比较差异无统计学意义(P>0.05);观察组患者的血液毒性(64.7%)、全身不良反应(厌食、疲劳)(76.5%)比率高于对照组(36.6%、26.8%)(P<0.05),但两组放射性食管炎(61.7%vs.63.4%)及放射性肺炎(64.7%vs.68.3%)患者比率组间比较差异无统计学意义(P>0.05);观察组患者的1年生存率为58.8%(20/34),高于对照组的39.0%(16/41),组间比较差异具有统计学意义(P<0.05)。结论适形调强放疗联合顺铂为基础的化疗治疗≥5cm的非小细胞肺癌可以提高整体治疗效果,提高患者1年生存率,虽然部分患者不良反应增加,但可以耐受,是一个相对较好的综合治疗方案。

Objective To observe the clinical efficacy and side effects of conformal intensity-modulated radiotherapy combined with or without chemotherapy in the treatment of non-small cell lung cancer ≥5 cm. Methods The clinical data of 75 patients with ≥5 cm non-small cell lung cancer who underwent conformal intensity-modulated radiotherapy from January 2015 to October 2017 in People's Hospital of Leshan City,Sichuan Province were retrospectively analyzed. Patients were divided into control group and observation group according to different treatment options. Patients in the control group (n=41) were given individualized conformal intensity-modulated radiotherapy,and patients in the observation group (n=34) were treated with cisplatin-based chemotherapy on the basis of individualized conformal intensity-modulated radiotherapy. The clinical outcomes,adverse events,and 1-year survival rates between the two groups were compared. Results The clinical effective rate of the observation group was 73.5%(25/34),which was higher than that of the control group (65.9%(27/41). There was no significant difference between the two groups ( P >0.05). The blood toxicity of the observation group was observed.(64.7%),the proportion of systemic adverse reactions (anorexia,fatigue)(76.5%) was higher than that of the control group (36.6%,26.8%)( P <0.05), but the two groups of radiation esophagitis (61.7% vs. 63.4%) and radioactivity There was no significant difference in the proportion of patients with pneumonia (64.7% vs. 68.3%)( P >0.05). The 1-year survival rate of the observation group was 58.8%(20/34),which was higher than that of the control group (39.0%)./41),the difference between groups was statistically significant ( P <0.05). Conclusion Conformal intensity-modulated radiotherapy combined with cisplatin-based chemotherapy for non-small cell lung cancer ≥5 cm can improve the overall treatment effect and improve the 1-year survival rate of patients. Although some adverse reactions are increased,patients can tolerate it. This protocol is a good comprehensive treatment plan.