图像引导大分割调强放疗联合安罗替尼治疗老年大肿块非小细胞肺癌患者有效性及安全性的临床研究  

Application of hypofractionated image-guided radiotherapy combined with anlotinib for the treatment of bulky non-small cell lung cancer in elderly patients: effectiveness and safety

作　　者：许晶 王强[1] 徐海亭[1] 丁曼华 张朦 杜傲男[1] 张涛[1] XU Jing;WANG Qiang;XU Haiting;DING Manhua;ZHANG Meng;DU Aonan;ZHANG Tao(Department of Radiotherapy,Xuzhou Cancer Hospital,Xuzhou,Jiangsu 221005,China)

机构地区：[1]徐州市肿瘤医院放疗科,江苏徐州221005

出　　处：《徐州医科大学学报》2022年第12期902-906,共5页Journal of Xuzhou Medical University

基　　金：江苏省六大人才高峰项目(YY-156)。

摘　　要：目的 探讨图像引导大分割调强放疗(HypoIGRT)联合安罗替尼治疗老年大肿块(肿瘤直径>7 cm)非小细胞肺癌(NSCLC)患者的临床疗效和安全性。方法 收集徐州市肿瘤医院2018年6月—2019年6月无法耐受手术及化疗的肿瘤直径>7 cm的28例老年NSCLC患者,给予HypoIGRT联合安罗替尼治疗并分析其疗效和毒性反应。结果 28例患者中完全缓解1例,部分缓解24例,稳定2例,进展1例,治疗客观缓解率(ORR)为89.3%。1年、2年、3年总生存(OS)率分别为73.6%、52.0%和26%,中位总生存期(mOS)为22.17个月。患者1年、2年、3年无进展生存(PFS)率分别为59.5%、26.8%和16.1%,中位无进展生存期(mPFS)为17.70个月。在毒副反应方面,放射性食管炎G0—1级者24例(85.71%),G≥2级者4例(14.29%),放射性肺炎G0—1级者23例(82.14%),G≥2级者5例(17.86%),另出现咯血9例(32.40%),高血压17例(60.71%),蛋白尿8例(28.57%),胃肠道反应7例(25.00%),手足皮肤反应5例(17.80%),多数为轻度且经对症处理后均可耐受。结论 HypoIGRT联合安罗替尼治疗老年大肿块NSCLC有效且耐受性良好。Objective To investigate the clinical effectiveness and safety of hypofractionated image-guided radiotherapy(HypoIGRT) combined with anlotinib for the treatment of bulky(> 7 cm) non-small cell lung cancer(NSCLC) in elderly patients.Methods A total of 28 elderly patients with bulky NSCLC(with > 7 cm in tumor diameter) who cannot tolerate surgery and chemotherapy in Xuzhou Cancer Hospital from June 2018 to June 2019 were enrolled. They were treated with HypoIGRT combined with anlotinib. The clinical effectiveness and adverse effects were analyzed.Results Among the 28 patients, there were 1 case of complete remission, 24 cases of partial remission, 2 cases of stable disease, and 1 case of progressive disease. The objective response rate(ORR) was 89.3%. The 1-, 2-, and 3-year overall survival rates were 73.6%, 52.0%, and 26%, respectively. The median overall survival(mOS) was 22.17 months. The 1-, 2-, and 3-year profession-free survival(PFS) rates were 59.5%, 26.8%, and 16.1%, respectively. The median profession-free survival(mPFS) was 17.70 months. In terms of toxicity, there were 24 cases(85.71%) of radiation esophagitis with G 0-1 and 4 cases(14.29%) with G≥2;23 cases(82.14%) of radiation pneumonitis with G 0-1 and 5 cases(17.86%) with G≥2. Furthermore, hemoptysis occurred in 9 cases(32.40%), hypertension in 17 cases(60.71%), proteinuria in 8 cases(28.57%), gastrointestinal disorders in 7 cases(25.00%), and hand-foot-skin reaction in 5 cases(17.80%), most of which were mild and tolerated after symptomatic treatment.Conclusions HypoIGRT combined with anlotinib is effective and well tolerated in the treatment of bulky NSCLC in elderly patients.

关 键 词：大分割调强放疗 安罗替尼 非小细胞肺癌 大肿块 

分 类 号：R734.2[医药卫生—肿瘤]