IMRT联合同期TP方案治疗不可手术Ⅲ期非小细胞肺癌  

Efficacy of IMRT intensity-modulated radiotherapy combined with concurrent TP regimen in the treatment of inoperable stage Ⅲ non-small cell lung cancer

作　　者：吴海波[1] 张小静[1] 张银 胡芳[1] 宋红梅[1] 桂金川 WU Haibo;ZHANG Xiaojing;ZHANG Yin;HU Fang;SONG Hongmei;GUI Jinchuan(Department of Oncology,Dazhou Central Hospital,Dazhou 635000,Sichuan,China)

机构地区：[1]达州市中心医院肿瘤科,四川达州635000

出　　处：《西部医学》2020年第9期1342-1345,1349,共5页Medical Journal of West China

基　　金：四川省科技创新苗子工程资助项目(2018138)。

摘　　要：目的探讨调强适形放疗(IMRT)联合同期紫杉醇+顺铂(TP)方案治疗不可手术Ⅲ期非小细胞肺癌(NSCLC)的临床疗效。方法回顾性分析2013年1月~2016年4月我院194例Ⅲ期NSCLC患者临床资料,根据其治疗方案分为传统同步放化疗组(传统组,61例)、单纯IMRT治疗(IMRT组,66例)及IMRT联合同期TP化疗方案治疗组(观察组,67例)。记录3组近期临床疗效、不良反应发生情况、放疗前及放疗后3个月时生存质量[Karnofsky体能状况(KPS)评分、Spitzer生活质量指数表(QLI)],并采用Kaplan-Meier法绘制3年生存曲线,使用Log-rank法比较3组3年生存率差异。结果IMRT组、传统组近期临床疗效比较差异无统计学意义(P>0.05),但均低于观察组(P<0.05)。3组白细胞减少、放射性食管炎发生情况比较差异无统计学意义(P>0.05);观察组与IMRT组放射性肺炎发生情况比较,差异无统计学意义(P>0.05),但传统组放射性肺炎发生率高于观察组及IMRT组(P<0.05)。放疗后3个月时,3组KPS、QLI评分均较治疗前升高(P<0.05),IMRT组、传统组KPS、QLI评分比较差异无统计学意义(P>0.05),但均低于观察组(P<0.05)。经Log-rank法检验,发现IMRT组、传统组3年生存率比较差异无统计学意义(P>0.05),但均低于观察组(P<0.05)。结论IMRT联合同期TP治疗Ⅲ期NSCLC效果显著,且不良反应少,亦能提高患者远期生存率,临床应用价值高。Objective To investigate the efficacy of intensity-modulated radiotherapy(IMRT)combined with concurrent taxel+cisplatin(TP)regimen in the treatment of inoperable stageⅢnon-small cell lung cancer(NSCLC).Methods The clinical data of 194 patients with stageⅢNSCLC in our hospital from January 2013 to April 2016 were retrospectively analyzed.According to the treatment regimens,they were divided into traditional concurrent chemoradiotherapy group(traditional group,61 cases),simple IMRT group(IMRT group,66 cases)and IMRT combined with concurrent TP chemotherapy regimen group(observation group,67 cases).The short-term clinical efficacy,occurrence of adverse reactions and quality of life[Karnofsky physical fitness status(KPS)score,Spitzer Quality of Life Index(QLI)]before radiotherapy and at 3 months after radiotherapy were recorded in the three groups.Kaplan-Meier method was used to draw the 3-year survival curves,and Log-rank method was used to compare the 3-year survival rates among the three groups.Results There was no statistically significant difference in the short-term clinical efficacy between IMRT group and traditional group(P>0.05),and was lower than that in observation group(P<0.05).There were no significant differences in the occurrence of leukopenia and radiation esophagitis among the three groups(P>0.05).There was no significant difference in the occurrence of radiation pneumonia between observation group and IMRT group(P>0.05),but the incidence rate of radiation pneumonia in traditional group was higher than that in observation group and IMRT group(P<0.05).After Log-rank test,it was found that there was no significant difference in the 3-year survival rate between IMRT group and traditional group(P>0.05),and was lower than that in observation group(P<0.05).Conclusion IMRT combined with concurrent TP in the treatment of stageⅢNSCLC has significant effects and less adverse reactions,and it can improve the long-term survival rate of patients and has high clinical application value.

关 键 词：NSCLC 调强适形放疗 TP化疗 生存率 生存质量 

分 类 号：R734.2[医药卫生—肿瘤]