立体定位放疗联合化疗对局部晚期非小细胞肺癌患者生存率的影响

Effects of stereotactic radiotherapy combined with chemotherapy on survival rate of patients with locally advanced non-small cell lung cancer

目的:观察立体定位放疗联合化疗对局部晚期非小细胞肺癌(LA-NSCLC)患者生存率的影响。方法:选取64例LANSCLC患者作为研究对象,按照随机数字表法将其分为对照组30例和研究组34例,对照组行常规放射治疗联合化疗,研究组行立体定位放射治疗联合化疗,比较两组临床疗效、血清肿瘤标志物水平的变化情况、不良反应发生情况及生存情况。结果:研究组的治疗有效率为82.4%(28/34),明显高于对照组的60.0%(18/30),差异有统计学意义(P<0.05);治疗后研究组糖类抗原125(CA125)、癌胚抗原(CEA)、转化生长因子β1(TGF-β1)水平均明显低于对照组,差异有统计学意义(P<0.05);研究组放射性肺炎发生率为8.8%(3/34),低于对照组的33.3%(10/30),差异有统计学意义(P<0.05);两组血液系统毒性、胃肠道反应及放射性食管炎发生率比较,差异无统计学意义(P>0.05);两组半年生存率比较,差异无统计学意义(P>0.05);研究组1年生存率、2年生存率均明显高于对照组,差异有统计学意义(P<0.05)。结论:立体定位放疗联合化疗应用在局部晚期非小细胞肺癌患者中,效果显著,可下调血清肿瘤标志物水平,提高患者1年、2年生存率,且可明显降低放射性肺炎发生率。

Objective: To observe effects of stereotactic radiotherapy combined with chemotherapy on survival rate of patients with locally advanced non-small cell lung cancer(LA-NSCLC).Methods:64 patients with LA-NSCLC were selected.According to the random number table method,they were divided into control group(n=30)and study group(n=34).The control group received conventional radiotherapy combined with chemotherapy,while the study group received stereotactic radiotherapy combined with chemotherapy.The clinical efficacies,changes in serum tumor marker levels,adverse reactions and survival rates were observed in the two groups.Results:The total effective rate of the study group was 82.4%(28/34),which was significantly higher than that of the control group(60.0%,18/30),and the difference was statistically significant(P<0.05).After the treatment,the levels of CA125,CEA,and TGF-β1 of the study group were significantly lower than those of the control group,and the differences were statistically significant(P<0.05).The incidence of radiation pneumonitis in the study group was 8.8%(3/34),which was lower than 33.3%(10/30)in the control group,and the difference was statistically significant(P<0.05).There were no significant differences in the blood system toxicity,gastrointestinal reactions and radiation esophagitis between the two groups(P>0.05).There was no significant difference in the halfyear survival rate between the two groups(P>0.05).The 1-year survival rate and 2-year survival rate of the study group were significantly higher than 40.0%of the control group,and the difference was statistically significant(P<0.05).Conclusions:Stereotactic radiotherapy combined with chemotherapy for the patients with locally advanced non-small cell lung cancer can down-regulate the serum tumor marker levels,improve the 1-year and 2-year survival rate,and can significantly reduce the incidence of radiation pneumonitis.