CT引导下大分割三维适形放疗对晚期非小细胞肺癌患者近远期疗效及血清肿瘤标志物的影响  

Treatment effects of image-guided hypo-fractionated three dimensional conformal radiotherapy on advanced non small cell lung cancer and influence on serum tumor markers

作　　者：陈锐[1] 叶敏[1] 黄林[1] 周红兵[2] 艾伟[2] 

机构地区：[1]四川省崇州市人民医院放射科,611230 [2]四川省崇州市人民医院呼吸内科,611230

出　　处：《中国医药》2015年第4期475-479,共5页China Medicine

摘　　要：目的 探讨CT引导下大分割三维适形放疗对晚期非小细胞肺癌（NSCLC）患者近远期临床疗效及血清肿瘤标志物的影响.方法 将2008年1月至2012年3月四川省崇州市人民医院诊治的98例晚期NSCLC患者按照随机数字表法分为CT引导下大分割三维适形放疗组（观察组）和常规三维适形放疗组（对照组）,每组49例.随访24个月,比较2组患者的临床近远期疗效及血清肿瘤标志物水平.结果 对照组患者治疗总体有效率为49.0％（24/49）,明显低于观察组的71.4％ （35/49） （P ＜0.05）.观察组患者的1、2年生存率分别为77.6％ （38/49）、53.1％ （26/49）,明显高于对照组患者的63.3％ （31/49）、40.8％ （20/49） （x2 =68.598,P＜0.01）.2组患者治疗后癌胚抗原、神经元特异性烯醇化酶、细胞角蛋白21-1片段、糖类抗原125和糖类抗原19-9均明显降低,并且观察组明显低于对照组,差异均有统计学意义[（8.9±1.4）μg/L比（19.4±4.9） μg/L、（11.2±2.0） μg/L比（20.5±4.6） μg/L、（2.2±0.5） μg/L比（4.0±1.0） μg/L、（31 ±6） U/ml比（46±9）U/ml、（29±7）U/ml比（47±15） U/ml],差异均有统计学意义（均P＜0.05）.结论 CT引导下大分割三维适形放疗对晚期NSCLC患者有明显的临床疗效,对血清肿瘤标志物的改善也呈现明显促进作用.Objective To investigate the curative effects of image-guided hypo-fractionated three dimen- sional conformal radiotherapy on advanced non small cell lung cancer （NSCLC） and the influence on the serum tumor markers. Methods Ninety-eight cases of NSCLC in Chongzhou City People＇s Hospital from January 2008 to March 2012 were were randomly divided into observation group （49 cases） receiving CT image guided hypo- fractionated three dimensional conformal radiotherapy and control group receiving conventional three-dimensional conformal radiotherapy group （49 cases）. The short- and long- term clinical therapeutic effect and the serum tumor marker levels were compared between the two groups. Results The overall efficiency of control group was 49.0% （24/49）, significantly lower than that in observation group [71.4% （35/49）, P 〈0.051. There were no signifi- cant differences in the disease control rate and adverse reaction incidence between the two groups （P 〉 0.05）. The 1, 2 year survival rates in observation group were 77.6% （38/49） and 53.1% （26/49）, obviously higher than those in control group [63.3% （31/49） and 40.8% （20/49） ,X2 =68. 598, P 〈0.01 ）. The serum tumor mark- ers such as carcinoembryonic antigen, neuron specific enolase, cytokeratin fragment 21-1, carbohydrate antigen 125 and carbohydrate antigen 19-9 were decreased obviously after treatment in both groups, and the changes in ob- servation group were significantly less than those in control group[ （8.9 ± 1.4） μg/L vs （ 19.4 ±4.9） μg/L, （11.2 ±2.0） μg/Lvs （20.5 ±4-.6） μg/L, （2,2±0.5）μg/Lvs （4.0±1.0） μg/L, （31 ±6） U/mlvs （46 ±9） U/ml, （29 ±7） U/ml vs （47 ± 15） U/roll （all P 〈0.05）. Conclusion Image-guided hypo-frac- tionated three dimensional conformal radiotherapy has obvious clinical efficacy on advanced NSCLC, meanwhile the serum tumor markers can be also improved correspondingly.

关 键 词：非小细胞肺癌 三维适形放疗 肿瘤标志物 

分 类 号：R445[医药卫生—影像医学与核医学]