调强适形放疗与三维适形放疗对局部晚期非小细胞肺癌患者肿瘤标志物及预后的影响

Effect of IMRT and 3D-CRT on tumor markers and prognosis in locally advanced NSCLC patients

目的探讨调强适形放疗(intensity modulated radio therapy,IMRT)与三维适形放疗(3D-conformal radiotherapy,3D-CRT)治疗对局部晚期非小细胞肺癌(locally advanced NSCLC,LA-NSCLC)患者肿瘤标志物及预后的影响。方法收集2016年8月~2017年8月收治的60例LA-NSCLC患者的临床资料,根据放疗方式分为IMRT组(30例)、3D-CRT组(30例)。记录并比较两组患者的临床疗效、预后及治疗前后的肿瘤标志物水平变化。结果两组患者的短期疗效、疾病控制率、客观有效率比较,差异无统计学意义(P>0.05)。放疗前,两组患者的癌胚抗原(carcinoembryonic antigen,CEA)、糖类抗原125(carbohydrate antigen 125,CA125)、鳞状细胞癌抗原(squamous cell careinoma,SCC)、细胞角蛋白19片段抗原(CYFRA21-1)等肿瘤标志物水平比较,差异无统计学意义(P>0.05);放疗后,两组患者的CEA、CA125、SCC、CYFRA21-1均低于放疗前,且IMRT组患者低于3D-CRT组患者,差异有统计学意义(P<0.001)。IMRT组患者的3年生存率为16.67%,高于3D-CRT组患者的10.00%,但差异无统计学意义(P>0.05)。IMRT组患者的总生存时间(overall survival,OS)、无进展生存时间(progress free survival,PFS)均大于3D-CRT组患者,差异有统计学意义(P<0.05)。结论IMRT与3D-CRT治疗局部晚期NSCLC患者的疗效相似,均可通过控制肿瘤来降低肿瘤标志物水平,并延长患者的生存期。

Objective To investigate the effects of intensity modulated conformal radiotherapy(IMRT)and three-dimensional conformal radiotherapy(3D-CRT)on tumor markers and prognosis in patients with locally advanced non-small cell lung cancer(LA-NSCLC).Methods Clinical data of 60 patients with LA-NSCLC admitted to our hospital from August 2016 to August 2017 were collected and divided into IMRT group(30 cases)and 3D-CRT group(30 cases)according to radiotherapy methods.Clinical efficacy,prognosis and changes in tumor marker levels before and after treatment were recorded and compared between the two groups.Results There was no statistically significant difference in short-term efficacy,disease control rate and objective effective rate between groups(P>0.05).Before radiotherapy,there was no statistically significant difference in the levels of tumor markers like carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),squamous cell careinoma(SCC),CYFRA21-1 between the two groups(P>0.05).After radiotherapy,CEA,CA125,SCC and CYFRA21-1 in the two groups were lower than those before radiotherapy,and those in the IMRT group were lower than those in the 3D-CRT group,and the difference was statistically significant(P<0.001).The 3-year survival rate of the IMRT group was 16.67%,which was higher than that of the 3D-CRT group(10.00%),but the difference was not statistically significant(P>0.05).Overall survival(OS)and progress free survival(PFS)in the IMRT group were both higher than those in the 3D-CRT group,with statistical significance(P<0.05).Conclusion IMRT and 3D-CRT have similar efficacy in patients with locally advanced NSCLC,both of which can reduce tumor marker levels and extend patient survival by controlling the tumor.