不同剂量分割模式放射治疗局限期小细胞肺癌的临床效果分析

Efficacy analysis of different dose fractionated mode radiotherapy for limited stage small cell lung cancer

目的 探讨3种剂量分割模式(常规分割、超分割、大分割)放射治疗局限期小细胞肺癌的临床效果及不良反应。方法选择2012年2月至2016年2月广东省农垦中心医院收治的局限期小细胞肺癌患者60例,采用根治性放化疗。依据剂量分割模式分为3组,常规分割组22例,超分割组30例,大分割组8例,比较3组患者的近期疗效、1年生存率、2年生存率及不良反应发生率等。结果常规分割组的近期治疗有效率为72.73%,与超分割组的80.00%和大分割组的87.50%比较差异均无统计学意义;大分割组的1年生存率显著高于常规分割组(87.50%vs.45.45%),差异有统计学意义(χ2=4.22,P<0.05);大分割组的2年生存率亦显著高于常规分割组(75.00%vs.31.82%),差异有统计学意义(χ2=4.45,P<0.05);超分割组1年生存率为63.33%,2年生存率为50.00%,与常规分割组比较差异无统计学意义,与大分割组比较差异亦无统计学意义;常规分割组不良反应发生率为18.18%,超分割组为20.00%,大分割组为0%,3组差异无统计学意义(χ2=1.87,P>0.05)。结论不同剂量分割模式放射治疗局限期小细胞肺癌均可获得一定的疗效,其中大分割模式放疗的生存获益最大。

Objective To investigate the clinical effects and adverse reactions of three dose division modes (conventional division,hyperdivision and large division) in radiotherapy for limited stage small cell lung cancer.Methods From February2012 to February2016,60 patients with limited stage small cell lung cancer admitted to Guangdong Nongken Central Hospital were selected for radical radiotherapy and chemotherapy.The patients were divided into groups according to the dose separation mode,including22 cases in the conventional division group,30 cases in the hyperdivision group and 8 cases in the large division group.The short-term efficacy,1-year survival rate,2-year survival rate and incidence rate of adverse reactions of the three groups were compared.Results The short-term effective rate of conventional segmentation group was 72.73%,and there was no significant difference compared with 80.00% of hypersegmentation group and 87.50% of large segmentation group.The1-year survival rate of the large segmentation group was significantly higher than that of the conventional segmentation group (87.50% vs.45.45%),with statistically significant difference (χ2=4.22,P < 0.05).The2-year survival rate of the large segmentation group was also significantly higher than that of the conventional segmentation group (75.00% vs.31.82%),and the difference was statistically significant (χ2=4.45, P < 0.05).The1-year survival rate and2-year survival rate of the hyperfractionated group were 63.33% and 50.00 %,respectively.There was no significant difference between the hyperfractionated group and the conventional fractionated group,nor was there any significant difference between the hyperfractionated group and the large fractionated group.Adverse reactions were18.18% in conventional segmentation group,20.00% in hypersegmentation group and 0.00% in large segmentation group.There was no significant difference among the three groups (χ2=1.87,P > 0.05).Conclusions Different dose fractionated radiotherapy can achieve certain therapeutic effects for localized small cell lung cancer,of which large fractionated radiotherapy has the greatest survival benefit.