γ-分次立体定向放射治疗不同分割方式对非小细胞肺癌脑转移瘤患者肿瘤标志物、NRS评分、侵袭性及预后的影响  

The effects of different segmentation methods ofγ-FSRT on the tumor marker,NRS score,invasiveness and prognosis of patients with NSCLC metastatic encephaloma

作　　者：李晓宇 张倬彬[1] 廖晓宁[1] 李书桢 张富亿 邱丽芳[1] 罗彪[1] LI Xiao-yu;ZHANG Zhuo-bin;LIAO Xiao-ning(Department of tumor radiotherapy,Affiliated Hospital of Youjiang Medical University for Nationalities,Baise Guangxi 533000,China)

机构地区：[1]右江民族医学院附属医院肿瘤放疗科,广西百色533000

出　　处：《中国医学装备》2021年第1期75-80,共6页China Medical Equipment

摘　　要：目的:探讨γ-分次立体定向放射治疗(γ-FSRT)的不同分割方式对非小细胞肺癌(NSCLC)脑转移患者的临床疗效及对肿瘤标志物基质金属蛋白酶9(MMP9)、N-钙粘蛋白(N-cadherin)、驱动蛋白超家族蛋白C1(KIFC1)、疼痛评分和预后的影响。方法:选取医院确诊的90例NSCLC脑转移患者,按照剂量分割方式的不同将其分为4 Gy/f,12 f组、5 Gy/f,8 f组和7 Gy/f,5 f组,每组30例。测量并比较治疗前后头部肿瘤体积、脑水肿程度,采用数字评级量表(NRS)评价疼痛程度,采用酶联免疫吸附测定(ELISA)法检测外周血MMP-9、N-cadherin及KIFC1蛋白的表达;治疗3个月后采用实体瘤疗效评价标准(RECIST)评价临床疗效,术后随访记录颅内无进展生存期和总生存期。结果:放射治疗后3组客观缓解率比较差异有统计学意义(x~2=9.370,P<0.05)。放射治疗后3组肿瘤平均体积和NRS评分均显著减小,3组比较差异有统计学意义(F=20.798,F=7.078;P<0.05);治疗后7 Gy/f,5 f组水肿程度显著轻于4 Gy/f,12 f组和5 Gy/f,8 f组,3组比较差异有统计学意义(x~2=13.824,P<0.05)。3组不良反应发生率差异无统计学意义。3组放射治疗后,外周血MMP-9、N-cadherin及KIFC1均显著下降,组间比较,7 Gy/f,5 f组显著低于4 Gy/f,12 f组和5 Gy/f,8 f组,差异有统计学意义(F=8.970, F=4.765,F=7.339;P<0.05)。3组放射治疗结束后24个月7 Gy/f,5 f组颅内无进展生存率和总生存率显著高于4 Gy/f,12 f组和5 Gy/f,8 f组,3组比较差异有统计学意义(x~2=3.963,x~2=4.125;P<0.05)。结论:7 Gy/f,5 f分割方式相对于5 Gy/f,8 f和4 Gy/f,12 f分割方式的γ-FSRT更有利于提高NSCLC脑转移患者的近远期疗效,并能够降低MMP-9、N-钙粘蛋白和KIFC1的表达,有利于减轻肿瘤的侵袭和转移和提高预后。Objective:To explore the effects of different segmentation methods ofγ-Fractionated stereotactic radiotherapy(γ-FSRT)on the clinically curative effect,the tumor markers such as matrix metalloproteinase 9(MMP9),N-cadherin,kinesin superfamily protein C1(KIFC1),Numerical Rating Scales(NRS)score and prognosis of patients with metastatic encephaloma of non-small cell lung cancer(NSCLC).Methods:90 patients with NSCLC metastatic encephaloma were selected and were divided into(4 Gy/f,12f)group,(5 Gy/f,8f)group and(7 Gy/f,5f)group,with 30 cases in each group.The tumor volume and the degree of cerebral edema pre and post treatment were measured and compared.And the numerical rating scales(NRS)was adopted to evaluate the degree of pain,and the enzyme-linked immunosorbent assay(ELISA)was adopted to detect the expressions of MMP-9,N-cadherin,KIFC1 in peripheral blood.And the response evaluation criteria in solid tumors(RECIST)was adopted to evaluate clinically curative effect after patients received treatment with 3 months.And the progression-free survival and total survival within cerebrum of patients were recorded by post-operation follow-up.Results:The difference of objective remission rates among three groups was statistically significant(x2=9.370,P<0.05).And the average volumes of tumor and NRS scores of three groups post radiotherapy were significantly reduced,and the difference of that among three groups was significant(F=20.798,F=7.078,P<0.05).After treatment,the degree of cerebral edema of(7Gy/f,5f)group was significantly less than that of(4 Gy/f,12f)group and(5 Gy/f,8f)group,and the difference of that among three groups was significant(x2=13.824,P<0.05).And the difference of adverse reaction rate among three groups was no significant.After radiotherapy,the degrees of MMP-9,N-cadherin and KIFC1 in peripheral blood of three groups were significantly reduced,and those of(7Gy/f,5f)group was significantly lower than those of(4Gy/f,12f)group and(5 Gy/f,8f)group(F=8.970,F=4.765,F=7.339,P<0.05),respectively.The progressio

关 键 词：非小细胞肺癌(NSCLC) 脑转移 γ-分次立体定向放射治疗(γ-FSRT) 基质金属蛋白酶9 N-钙粘蛋白 驱动蛋白超家族蛋白C1(KIFC1) 

分 类 号：R816.41[医药卫生—放射医学]