IMRT联合高压氧治疗中晚期非小细胞肺癌的疗效观察

CLINICAL EFFECTS OBSERVATION OF HBO COMBINED WITH IMRT IN NSCLC WITH ADVANCED STAGE

目的探讨调强放射治疗(intensity-modulated radiation therapy,IMRT)联合高压氧治疗中晚期非小细胞肺癌的临床疗效。方法选取2015年1月—2019年12月就诊于湖南省人民医院肿瘤科的非小细胞肺癌患者64例,采取随机数字表法将其分成联合治疗组和单纯治疗组,各32例,二组患者均在同步化疗基础上予以肺部原发灶及淋巴结累及野放疗,但联合治疗组在放疗期间联合高压氧治疗。比较二组患者近期临床疗效、放射性肺损伤以及生活质量情况。结果联合治疗组和单纯治疗组患者的近期疗效比较,联合治疗组患者其疾病控制率优于单纯治疗组(90.6%vs.71.9%,P=0.05),但二组患者总体有效率比较差异无统计学意义(62.5%vs.59.4%,P=0.80)。且通过二组患者追踪随访发现总体生存率差异无统计学意义(Log Rank=1.77,P=0.18)。二组患者临床疗效比较,联合治疗组患者急性放射性肺损伤和慢性放射性肺损伤均低于单纯治疗组(Z=-2.07,P=0.04和Z=-2.13,P=0.03)。二组患者治疗半年后生活质量评分均较治疗前有明显改善,但与单纯治疗组患者比较,高压氧联合治疗对于改善患者气促、胸痛更为明显(均P<0.05)。结论 IMRT联合高压氧治疗中晚期非小细胞肺癌患者虽无法提高患者总体生存率,但能明显降低放射性肺损伤发生率,并能改善患者气促、胸痛等症状,从而提高患者生活质量。

Objective To evaluate the effect of hyperbaric oxygen(HBO) combined with IMRT in NSCLC with advanced stage.Methods From February 2017 to December 2019,sixty four patients with advanced non-small cell lung cancer admitted in People′s Hospital of Hunan Province were selected as the study objects and divided into Combine Treatment group(CTG) and Treatment-Only group(TOG) randomly.CTG was treated with IMRT for primary lung and lymph node involvement on the basis of concurrent chemotherapy,and CTG was combined with hyperbaric oxygen therapy during radiotherapy combined with HBO(Hyperbaric).Radiation-induced lung injury and quality of life in two groups of patients were compared.Results Comparing the short-term efficacy of patients in CTG and GOG,the disease control rate of CTG was better than that of GOG(90.6% vs.71.9%,P=0.05),but there was no statistical difference in the overall effective rate between the two groups(62.5% vs.59.4%,P=0.80).And through the follow-up of the two groups of patients,the overall survival rate was not statistically significant(Log Rank=1.77,P=0.18).In addition,the rate of radiation-induced lung injury in CTG was significantly lower than GOG(Z=-2.07,P=0.04 and Z=-2.13,P=0.03).After half a year of treatment,the life treatment scores of the two groups were significantly improved,compared with those before the treatment.But compared with the patients in TOG,the hyperbaric oxygen treatment was more obvious in improving shortness of breath and chest pain in CTG(P<0.05).Conclusion HBO has an auxiliary effect on tumor treatment of IMRT in patients with advanced non-small cell lung cancer.It can significantly improve the disease control rate and progression-free survival rate of patients,reduce the incidence of radiation-induced lung injury and help improve the quality of life of patients.And it is worthy to recommend for clinical application.