三维适形放疗与调强放疗对晚期非小细胞肺癌患者血清肿瘤标志物及剂量学参数比较研究

A comparative study of serum tumor markers and dosimetry parameters in patients with advanced non-small cell lung cancer treated with three dimensional conformal radiotherapy and intensity modulated radiotherapy

目的 比较研究调强放疗与三维适形放疗对晚期非小细胞肺癌患者血清肿瘤标志物及剂量学参数的影响.方法 回顾性选取2021年6月-2023年3月玉林桂南医院肿瘤科晚期非小细胞肺癌患者64例,依据治疗方法分为调强放疗治疗组、三维适形放疗组两组,每组各32例.统计分析两组临床疗效、血清肿瘤标志物、VEGF亚型、免疫因子、剂量学参数、不良反应发生情况、生存情况.结果 两组患者的总缓解率、VEGFA、VEGFB、VEGFC水平、CD3^(+)CD4^(+)T细胞、CD3^(+)CD8^(+)T细胞、CD4^(+)/CD8^(+)T细胞、计划靶区平均剂量、3年生存率之间的差异不显著(P>0.05).调强放疗治疗组患者的血清SCC、CEA、CA125、CYFRA21-1、TSGF水平均低于三维适形放疗组(P<0.05),CI、HI均高于三维适形放疗组(P<0.05),不良反应发生率低于三维适形放疗组(P<0.05),无进展生存期、总生存期均长于三维适形放疗组(P<0.05).结论 晚期非小细胞肺癌调强放疗较三维适形放疗更能将患者血清肿瘤标志物水平降低,对患者剂量学参数进行改善.

Objective To compare the effects of intensity modulated radiotherapy and three-dimensional conformal radiotherapy on serum tumor markers and dosimetry parameters in patients with advanced non-small cell lung cancer.Methods 64 patients with advanced non-small cell lung cancer from June 2021 to March 2023 in the Department of Oncology,Yulin Guinan Hospital were retrospectively selected and divided into two groups according to treatment methods:intensity modulated radiotherapy treatment group and three-dimensional radiotherapy treatment group,32 cases in each group.Clinical efficacy,serum tumor markers,VEGF subtypes,immune factors,dosimetry parameters,occurrence of adverse reactions and survival of the two groups were statistically analyzed.Results There were no significant differences in overall response rate,VEGFA,VEGFB,VEGFC levels,CD3^(+)CD4^(+)T cells,CD3^(+)CD8^(+)T cells,CD4^(+)/CD8^(+)T cells,mean dose in planned target area,and 3-year survival between the two groups(P>0.05).The levels of serum SCC,CEA,CA125,CYFRA21-1 and TSCF in intensity IMRT group were lower than those in 3D radiotherapy group(P<0.05),CI and HI were higher than those in 3D radiotherapy group(P<0.05),and the incidence of adverse reactions was lower than that in 3D radiotherapy group(P<0.05).Progression-free survival and overall survival were both longer than those in the three dimensional radiotherapy group(P<0.05).Conclusion Intensity modulated radiotherapy is more effective than three-dimensional conformal radiotherapy in reducing the level of serum tumor markers and improving the dosimetric parameters of patients with advanced non-small cell lung cancer.