同期推量调强放疗与序贯推量调强放疗治疗老年局晚期非小细胞肺癌的效果比较  

Effect comparison of SIB-IMRT and SEQ-IMRT for the treatment of el-derly patients with locally advanced non-small cell lung cancer

作　　者：吴阳[1] 李亮[1] 余红民[2] 

机构地区：[1]徐州医学院附属医院放疗科,徐州221002 [2]徐州医学院公共卫生学院,徐州221004

出　　处：《中国当代医药》2015年第26期42-45,共4页China Modern Medicine

摘　　要：目的比较老年局晚期非小细胞肺癌（LA-NSCLC）患者采取同期推量调强放疗（SIB-IMRT）与序贯推量调强放疗（SEQ-IMRT）的效果。方法回顾性分析徐州医学院附属医院2010年1月~2014年10月住院的56例老年LA-NSCLC患者,随机分为治疗组（28例,采用SIB-IMRT）和对照组（28例,采用SEQ-IMRT）。比较两组患者放疗计划不同参数的剂量及两组患者的近期疗效和急性毒副反应。结果 SIB-IMRT组肿瘤靶区内生物等效剂量（BED）（95.3±4.7）Gy高于SEQ-IMRT组的（86.4±3.2）Gy,差异有统计学意义（P〈0.05）;SIB-IMRT组和SEQ-IMRT组的靶区适形指数分别为（81.8±1.3）%和（80.2±1.8）%,两组比较差异无统计学意义（P〉0.05）;两组靶区肺受照相关体积、肺平均受照剂量、脊髓受照最大剂量、心脏受照相关体积比较,差异无统计学意义（P〉0.05）。治疗组总有效率（CR＋PR）为82.1%,对照组总有效率为46.4%,两组比较差异有统计学意义（P〈0.05）。两组患者均未发生Ⅲ级以上的毒副反应,发生Ⅰ~Ⅱ级放射性肺损伤、放射性食管炎、急性骨髓抑制比较差异无统计学意义（P〉0.05）。结论 SIB-IMRT与SEQ-IMRT治疗老年LA-NSCLC,前者可获得理想的剂量分布,可提高肿瘤靶区内的BED且未增加周围危及器官剂量,可提高近期疗效且急性毒副反应无增加。Objective To compare the radiotherapy effect between SIB-IMRT and SEQ-IMRT in treating elderly pa- tients with locally advanced non-small cell lung cancer （LA-NSCLC）. Methods 56 Patients with LA-NSCLC from Jan- uary 2010 to October 2014 in our hospital were retrospectively analyzed.Patients were randomly divided into treatment group （n=28） and control group （n=28）.The control group were given SEQ-1MRT and the treatment group were given SIB-IMRT.Then the dosimetry of different parameters in radiotherapy plans,efficacy and acute toxicities between two groups was compared respectively. Results The BED of tumor target zone in treatment group was （95.3±4.7）Gy,signifi- cantly higher than that of （86.4±3.2）Gy in control group,and the difference was statistically significant （P〈0.05）.The CI between two groups was （81.8±1.3）% and （80.2±1.8）% respectively,and the difference had no statistically significant（P〉 0.05）.There were no statistically significant between two groups in target illuminated lung volume,mean lung dose,the maximum dose of spinal cord illuminated and heart illuminated volume （P〉0.05）.The total efficacy rate was 82.1% in treatment group and 46.4% in control group,the difference was statistically significant （P〈0.05）.There were no adverse reaction more than Ⅲ magnitude occ,red,and all of Ⅰ to Ⅱ magnitude adverse reaction such as radioactive lung reac- tion,radioactive esophagitis,acute bone marrow suppression had no statistically significant between two groups （P〉0.05）. Conclusion Comparing SIB-IMRT with SEQ IMRT in treating elderly LA-NSCLC,the former can obtain ideal dose dis- tribution,increase the BED of tumor target zone,increase in the near future curative effect,but do not increase the sur- rounding organs threatening dose and acute toxicity.

关 键 词：非小细胞肺癌 放射治疗 调强放疗 剂量学 

分 类 号：R734.2[医药卫生—肿瘤]