局部晚期肺癌三维适型放射治疗和调强放射治疗的剂量学比较

Dosimetric Comparison of Three-dimensional Conformal Radiotherapy and Intensity-modulated Radiotherapy for Locally Advanced Lung Cancer

目的比较对局部晚期肺癌患者分别采用三维适型放疗(3D-conformal radiotherapy,3D-CRT)与调强放疗(intensity modulated radiation therapy,IMRT)的临床疗效,分析其对剂量学参数、免疫功能所产生的影响。方法选取2020年1月—2020年12月金乡县人民医院肿瘤科诊治的22例局部晚期肺癌患者作为研究对象,按照随机数表法分为A组和B组,各35例,A组给予IMRT,B组给予3D-CRT,对比两组临床疗效、剂量学参数及免疫因子水平、不良反应发生情况。结果两组治疗总有效率、治疗后CD3^(+)CD8^(+)、CD3^(+)CD4^(+)T细胞水平及平均剂量对比,差异无统计学意义(P>0.05)。A组剂量学中的适形指数(conformity index,CI)、异质性指数(heterogeneity index,HI)较B组高,差异有统计学意义(P<0.05)。A组治疗期间不良反应发生率较B组低,差异有统计学意义(P<0.05)。结论针对局部晚期肺癌患者,采用IMRT、3D-CRT皆可获得良好效果,而IMRT能够优化肿瘤靶区剂量,提高靶区适形度,且不良反应更少。

Objective To compare the clinical efficacy of three-dimensional conformal radiotherapy(3D-CRT)and intensity-modulated radiation therapy(IMRT)in patients with locally advanced lung cancer.Analyze its impact on do-simetric parameters and immune function.Methods 22 patients with locally advanced lung cancer diagnosed and treated in the Department of Oncology of Jinxiang County People's Hospital from January 2020 to December 2020 were selected as the study objects,and were divided into group A and Group B with 35 cases in each group according to random number table method.Group A was given IMRT and group B was given 3D-CRT.The clinical efficacy,do-simetry parameters,levels of immune factors and occurrence of adverse reactions of the two groups were compared.Results There was no statistically significant difference in total response rate,CD3^(+)CD8^(+),CD3^(+)CD4^(+)T cell level and average dose between the two groups(P>0.05).The conformity index(CI)and heterogeneity index(HI)in dosimetry of group A were higher than those of group B,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in group A was lower than that in group B,and the difference was statistically significant(P<0.05).Conclusion For patients with locally advanced lung cancer,both IMRT and 3D-CRT can achieve good results,and IMRT can optimize the dose of the tumor target area,improve the conformity of the target area,and have fewer adverse reactions.