立体定向放疗与调强放疗治疗不适宜手术的Ⅰ期非小细胞肺癌患者的疗效对比分析  

A comparative analysis of the effects of SBRT and IMRT for stage Ⅰ non-small cell lung cancer patients unsuitable for surgery

作　　者：熊耀祖 仝宇梭 周锡垒[1] 潘鹏[1] 戴婷婷 李涛[1] 于长华[1] XIONG Yaozu;TONG Yusuo;ZHOU Xilei;PAN Peng;DAI Tingting;LI Tao;YU Changhua(Department of Radiotherapy,Huai'an First People's Hospital,Jiangsu Huai'an 223001,China)

机构地区：[1]淮安市第一人民医院放疗科,江苏淮安223001

出　　处：《现代肿瘤医学》2022年第5期824-828,共5页Journal of Modern Oncology

基　　金：国家自然科学青年基金(编号:H1617/81602118)。

摘　　要：目的:回顾性对比分析接受立体定向放疗(stereotactic body radiation therapy, SBRT)与调强放疗(intensity modulated radiation therapy, IMRT)治疗不适宜手术的Ⅰ期非小细胞肺癌患者的治疗效果及不良反应。方法:回顾性分析接受SBRT或IMRT放射治疗的Ⅰ期非小细胞肺癌患者45例,其中,接受SBRT治疗者21例,接受IMRT治疗者24例。比较二者的局部控制率、区域控制率、无进展生存率、远处转移控制率、肿瘤特异性生存率、总生存率及治疗相关不良反应。结果:SBRT组对比IMRT组显著提高了肿瘤的局部控制率、区域控制率以及无进展生存率。两者的1年、2年、3年肿瘤局部控制率分别为(100%、94.4%、63.2%) vs (87.0%、52.2%、39.1%)(P=0.037)。1年、2年、3年的区域控制率分别为(90.3%、63.3%、45.3%) vs (65.5%、37.4%、 23.3%)(P=0.041)。1年、2年、3年无进展生存率分别为(80.4%、48.5%、43.1%) vs (52.5%、21.9%、17.5%)(P=0.042)。而SBRT组在远处转移控制率,肿瘤相关性生存率及总生存率上对比IMRT组未体现出优势。两者的1年、2年、3年远处转移控制率分别为(85.2%、64.2%、48.1%) vs (91.4%、54.9%、41.2%)(P=0.803)。1年、 2年、 3年总生存率分别为(95.2%、81.0%、61.9%) vs (95.8%、83.3%、66.7%)(P=0.735)。1年、2年、3年肿瘤特异性生存率分别为(100%、89.5%、68.4%) vs (100%、90.9%、72.7%)(P=0.75)。治疗期间,两组间治疗相关不良反应相当,无明显差别。结论:在I期非小细胞肺癌的放射治疗上,SBRT对比IMRT具有提高局部控制率、区域控制率及无进展生存率的优势,但在远处转移控制率、肿瘤相关性生存率及总生存率上,两者无明显差别。临床医师可根据患者的不同状况选择适合的放射治疗方法。Objective:To retrospectiveiy compare the therapeutic effects and adverse reactions of stage Ⅰ non-small cell lung cancer patients unsuitable for surgery treated with SBRT and IMRT.Methods:Retrospective analysis was performed on 45 patients with stage Ⅰ non-small cell lung cancer who received SBRT or IMRT radiotherapy, including 21 patients who received SBRT and 24 patients who received IMRT.Local control rate, regional control rate, progression-free survival rate, distant metastasis control rate, tumor-specific survival rate, overall survival rate and treatment-related adverse reactions were compared between the two groups.Results:Compared with IMRT group, SBRT group significantly improved the tumor local control rate, regional control rate and progression-free survival rate.The 1-year, 2-year and 3-year local tumor control rates were(100%,94.4%,63.2%) vs(87.0%,52.2%, 39.1%),respectively(P=0.037).The regional control rates for 1 year, 2 years and 3 years were(90.3%,63.3%,45.3%) vs(65.5%,37.4%,23.3%) respectively(P=0.041).The 1-year, 2-year, and 3-year progression-free survival rates were(80.4%,48.5%,43.1%) vs(52.5%,21.9%,17.5%)(P=0.042) respectively.However, SBRT group showed no advantages in distant metastasis control rate, tumor-related survival rate and overall survival rate compared with IMRT group.The 1-year, 2-year and 3-year distant transfer control rates were(85.2%,64.2%,48.1%) vs(91.4%,54.9%,41.2%)(P=0.803).1-year, 2-year, and 3-year overall survival rates were(95.2%,81.0%, 61.9%) vs(95.8%,83.3%,66.7%)(P=0.735),respectively.The 1-year, 2-year, and 3-year tumor-specific survival rates were(100%,89.5%,68.4%) vs(100%,90.9%,72.7%)(P=0.75),respectively.During the treatment period, there was no significant difference in treatment related adverse reactions between the two groups.Conclusion:In radiotherapy for stage I NSCLC,SBRT has the advantages of improving local control rate, regional control rate and progression-free survival rate compared with IMRT,but there is no significant difference in distant meta

关 键 词：非小细胞肺癌 立体定向放疗 调强放疗 

分 类 号：R734.2[医药卫生—肿瘤]