三维适形放疗与调强放疗治疗老年非小细胞肺癌的效果比较

Effect of three dimensional conformal radiotherapy versus intensity modulated radiotherapy on elderly patients with non-small cell lung cancer

目的观察比较三维适形放疗(3D-CRT)与调强放疗治疗老年非小细胞肺癌(NSCLC)的效果和不良反应。方法抽取2018年1月至2020年12月商丘市第一人民医院收治的老年NSCLC患者112例,按随机数字表法分为调强放疗组(56例)与3D-CRT组(56例)。3D-CRT组采用3D-CRT,调强放疗组采用调强放疗。比较两组疾病控制率、靶区剂量、血清肿瘤标志物[细胞角蛋白19可溶性片段(CYFRA21-1)、血管内皮生长因子(VEGF)、糖类抗原125(CEA125)]、免疫功能(T淋巴细胞亚群CD3^(+)、CD8^(+))及不良反应发生率。结果调强放疗组疾病控制率(69.64%,39/56)高于3D-CRT组(46.43%,26/56),P<0.05。调强放疗组适形数值、靶区数值高于3D-CRT组(P<0.05)。治疗后,调强放疗组血清CYFRA21-1、VEGF、CA125低于3D-CRT组(P<0.05)。治疗后,调强放疗组CD3^(+)高于3D-CRT组,CD8^(+)低于3D-CRT组(P<0.05)。调强放疗组不良反应发生率(12.50%,7/56)低于3D-CRT组(30.36%,17/56),P<0.05。结论与3D-CRT相比,调强放疗应用于老年NSCLC患者治疗中,可改善免疫功能,增加靶区剂量,下调血清肿瘤标志物水平,提高疾病控制率,且不良反应发生率低,安全性高。

Objective To observe and compare the effects and adverse reactions of three dimensional conformal radiotherapy(3D-CRT)versus intensity modulated radiotherapy(IMRT)on elderly patients with non-small cell lung cancer(NSCLC).Methods A total of 112 elderly NSCLC patients treated in Shangqiu First People’s Hospital from January 2018 to December 2020 were selected and divided into IMRT group(56 cases)and 3D-CRT group(56 cases)according to random number table method.The 3D-CRT group was treated by 3D-CRT,and the IMRT group was treated by IMRT.The disease control rate,target dose,serum tumor markers,including CYFRA21-1(cytokeratin-19-fragment),vascular endothelium growth factor(VEGF),carbohydrate antigen 125(CA125),immune function assessed by T lymphocyte subsets including cluster of differentiation(CD)3^(+)and CD8^(+),and the incidences of adverse reactions were compared between the two groups.Results The disease control rate of IMRT group(69.64%,39/56)was higher than that of 3D-CRT group(46.43%,26/56),P<0.05.The conformal values and target area values of IMRT group were higher than those of 3D-CRT group(P<0.05).After treatment,the levels of serum CYFRA21-1,VEGF and CA125 in IMRT group were lower than those in 3D-CRT group(P<0.05).After treatment,CD3^(+)and CD8^(+)in IMRT group were higher and lower than those in 3D-CRT group(P<0.05).The incidence of adverse reactions in IMRT group was 12.50%(7/56),lower than 30.36%(17/56)in 3D-CRT group(P<0.05).Conclusions Compared with 3D-CRT,the application of IMRT in the treatment of elderly NSCLC patients can improve immune function,increase target dose,down-regulate serum tumor markers,improve disease control rate,with low incidence of adverse reactions and high safety.