不同放疗剂量在局部晚期肺癌中的应用及其安全性分析

Application and safety analysis of different radiation doses in locally advanced lung cancer

目的探讨不同放疗剂量在局部晚期肺癌中的应用及其安全性。方法回顾性选择2023年3月至12月在本院放疗科接受治疗的局部晚期肺癌患者75例进入试验,根据患者的耐受情况分为高剂量组和低剂量组,其中低剂量组(38例,放疗剂量45 Gy),高剂量组(37例,放疗剂量65 Gy),对比分析2组患者的临床疗效、疾病控制率、生存率、复发率、血清指标、毒副作用以及免疫因子水平。结果治疗后,高剂量组临床治疗有效率97%,低剂量组87%(χ^(2)=1.545,P>0.05);高剂量组和低剂量组的疾病控制率(86%和66%)、复发率(68%和89%)和生存率(18%和3%)比较有统计学意义(P<0.05);2组血清指标水平均下降,且高剂量组血清癌胚抗原(CEA)、糖类抗原(CA)125、CA19-9、细胞角蛋白19片段(CYFRA21-1)水平高于低剂量组(P<0.05);高剂量组的恶心呕吐、肝肾功能异常等5项毒副反应发生率高于低剂量组(P<0.05);治疗后,高剂量组的CD8^(+)(35.7±4.3)%高于低剂量组(30.3±4.8)%、且高剂量组的CD4^(+)(31.3±4.7)%和CD4^(+)/CD8^(+)(0.89±0.18)分别低于低剂量组的CD4^(+)(37.9±4.82)%和CD4^(+)/CD8^(+)(1.22±0.34),差异有统计学意义(P<0.05)。结论高剂量放疗在局部晚期肺癌疾病控制中的效果优于低效量放疗,复发率低,但低剂量安全性更高。

Objective To explore the application and safety of different radiation doses in locally advanced lung cancer.Methods Seventy-five locally advanced lung cancer patients who received treatment in the radiotherapy department from March 2023 to December 2023 were selected for the trial.According to the tolerance of patients,these 75 patients were divided into high-dose group and low-dose group,with low-dose group(38 cases,radiotherapy dose of 45 Gy)and high-dose group(37 cases,radiotherapy dose of 65 Gy).The clinical efficacy,disease control rate,survival rate,recurrence rate,serum indicators,toxic side effects,and immune factor levels of the two groups of patients were compared and analyzed.Results After treatment,the clinical effective rate was 97.3%in the high-dose group and 86.84%in the low-dose group(χ^(2)=1.545,P>0.05).The disease control rates(86%,66%),recurrence rates(68%,89%),and survival rates(18%,3%)between the high-dose and low-dose groups were statistically significant(P<0.05).The serum levels of CEA,CA125,CA19-9 and CYFRA21-1 in the high-dose group were higher than those in the low-dose group(P<0.05).The incidence of five toxic side effects,including nausea and vomiting and abnormal liver and kidney function,was higher in the high-dose group than in the low-dose group(P<0.05).After treatment,the CD8^(+)(35.7±4.3)%of the high-dose group was higher than that of the low-dose group(30.3±4.8)%,and the CD4^(+)(31.3±4.7)%and CD4^(+)/CD8^(+)(0.89±0.18)of the high-dose group were respectively lower than those of the low-dose groupCD4^(+)(37.9±4.8)%and CD4^(+)/CD8^(+)(1.22±0.34),the difference was statistically significant(P<0.05).Conclusion High dose radiotherapy is more effective in controlling locally advanced lung cancer than low-dose radiotherapy,but low-dose radiotherapy has higher safety.