不同分割剂量超分割放疗对局限期小细胞肺癌患者近远期疗效及毒副反应的影响  

Impacts of hyperfractionated radiotherapy at different fractionated doses on short-and long-term efficacy and toxicity in patients with limited stage small cell lung cancer

作　　者：徐彦 赵世恩 于昌徐 叶鑫 魏世鸿[2] XU Yan;ZHAO Shien;YU Changxu;YE Xin;WEI Shihong(Department of Oncology,Zhangye People s Hospital Affiliated to Hexi University,Zhangye,Gansu 734000,China;不详)

机构地区：[1]河西学院附属张掖人民医院肿瘤科,甘肃张掖734000 [2]甘肃省肿瘤医院放疗科,甘肃兰州730050

出　　处：《中国临床研究》2024年第1期34-38,共5页Chinese Journal of Clinical Research

基　　金：甘肃省卫生健康行业科研项目(GSWSKY2021-057);兰州市人才创新创业项目(2021-RC-130)。

摘　　要：目的 探讨对局限期小细胞肺癌(SCLC)患者采用不同分割剂量超分割放疗治疗的近远期疗效及毒副反应。方法 选取2017年8月至2019年8月在张掖人民医院收治的局限期SCLC患者70例,按照随机数字表法分为对照组(n=35)和观察组(n=35),两组患者都采用常规化疗和超分割放疗,对照组放疗的总剂量是45 Gy,观察组放疗的总剂量是60 Gy。进行为期3年的随访,比较两组患者的近期疗效、远期疗效(生存率和局部控制率)、毒副反应的发生情况。结果 观察组患者总有效率优于对照组(91.43%vs 71.43%,χ^(2)=4.629,P=0.031);观察组患者1、2、3年的局部控制率和生存率高于对照组(P<0.05)。两组不良反应总发生率差异无统计学意义(P>0.05),且不良反应多为Ⅰ~Ⅱ级,不影响疗程。两组生活质量评分在治疗后均升高(P<0.01),且观察组高于对照组(P<0.01)。结论 超分割放疗治疗局限期SCLC患者,适当加大分割剂量,则近远期疗效更好,局部控制率和生存率更高,且毒副反应未明显增多,安全性较好,可以提高患者的生活质量。Objective To explore the short-and long-term efficacy and toxic and side effects of hyperfractionated radiotherapy with different fractionated doses in patients with limited stage small cell lung cancer(SCLC).Methods From August 2017 to August 2019,70 patients with limited stage SCLC admitted to Zhangye People s Hospital were selected and divided into control group(n=35)and observation group(n=35)according to the random number table method.Conventional chemotherapy and hyperfractionated radiotherapy were used in both groups,with a total dose of 45 Gy in the control group and 60 Gy in the observation group.A three-year follow-up was carried out to compare the short-and long-term efficacy(survival and local control rate),and the occurrence of toxic and side effects between the two groups.Results The total effective rate in the observation group was obviously higher than that in the control group(91.43%vs 71.43%,χ^(2)=4.629,P=0.031).The 1-,2-,and 3-year local control rates and survival rates of patients in the observation group were significantly higher than those in the control group(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05),and most of adverse reactions were gradeⅠ-Ⅱ,which did not affect the course of treatment.After treatment,the scores of life quality in both groups increased significantly(P<0.01),and the observation group showed a significant increase compared to the control group(P<0.01).Conclusion Hyperfractionnated radiotherapy with appropriately increased fractionated dose for patients with limited stage SCLC has better short-and long-term efficacy,higher local control rate and survival,and no significant increase in toxic and side effects,which is safe and can improve the quality of patients life.

关 键 词：超分割放疗 局限期 小细胞肺癌 疗效 近期 远期 毒副反应 

分 类 号：R734.2[医药卫生—肿瘤]