不同剂量调强放疗联合同步化疗对局部晚期肺癌患者生存期和毒副反应的影响  

Effects of different doses of intensity-modulated radiotherapy combined with concurrent chemotherapy on survival and toxicity in patients with locally advanced lung cancer

作　　者：江承川[1] 李茉莉 刘莎 朱中山[1] 李小兵 JIANG Chengchuan;LI Moli;LIU Sha;ZHU Zhongshan;LI Xiaobing(Department of Oncology,Hunan Brain Hospital(the Second People's Hospital of Hunan Province),Changsha 410007,China;Department of Respiratory and Critical Care Medicine,Chenzhou No.1 People's Hospital,Chenzhou 423000,China)

机构地区：[1]湖南省脑科医院(湖南省第二人民医院)肿瘤科,湖南长沙410007 [2]郴州市第一人民医院呼吸与危重症医学科,湖南郴州423000

出　　处：《中国医学物理学杂志》2022年第11期1345-1348,共4页Chinese Journal of Medical Physics

基　　金：湖南省卫生健康委科研计划(B2019048)。

摘　　要：目的:探讨不同剂量调强放疗联合同步化疗对局部晚期肺癌患者生存期和毒副反应的影响。方法:选取96例确诊为局部晚期肺癌患者为研究对象,随机分为对照组(n=48)和观察组(n=48)。对照组采用62 Gy调强放疗联合PC同步化疗,观察组调整放疗剂量为50 Gy。记录患者临床一般资料。K-M分析绘制生存曲线,Log Rankχ^(2)检验比较生存率,记录两组患者治疗1个月后毒副反应发生情况。结果:观察组和对照组患者缓解率无显著差异(75.00%vs79.17%,P>0.05);观察组患者总生存率和无进展生存率均高于对照组(P<0.05),中位生存时间显著长于对照组(P<0.05)。观察组骨髓抑制和放射性肺炎等放疗毒副反应发生率显著低于对照组(P<0.05)。结论:通过降低调强放疗剂量能够减轻患者毒副反应,提高患者生存期,联合同步化疗能够发挥良好的临床缓解效应。Objective To explore the effects of different doses of intensity-modulated radiotherapy(IMRT)combined with concurrent chemotherapy on survival and toxicity in patients with locally advanced lung cancer.Methods A total of 96 patients with locally advanced lung cancer were randomly divided into control group(n=48)and observation group(n=48).The control group was treated with IMRT(62 Gy)and concurrent PC chemotherapy,while the IMRT dose in observation group was 50 Gy.The general clinical data of patients were recorded.The survival curves were drawn using K-M analysis,and the survival rates were compared using Log Rankχ^(2) test.The incidence of radiation-induced toxicity in 1 month after treatment was recorded.Results The remission rate in observation group was 75.00%,close to 79.17%in control group(P>0.05).The overall survival rate and progressionfree survival rate in observation group were higher than those in control group(P<0.05),and the median survival time was significantly longer than that in control group(P<0.05).The incidences of radiation-induced toxicity such as bone marrow suppression and radiation pneumonitis in observation group were significantly lower than those in control group(P<0.05).Conclusion Reducing IMRT dose can relieve radiation-induced toxicity and prolong survival in patients.IMRT combined with concurrent chemotherapy can cause favorable clinical remission.

关 键 词：局部晚期肺癌 调强放射治疗 药物治疗 生存期 毒副反应 

分 类 号：R816.41[医药卫生—放射医学]