序贯放化疗与同步放化疗对不可手术切除非小细胞肺癌患者的疗效及毒性反应对比  

Comparison of efficacy and toxicity reactions between sequential chemoradiotherapy and concomitant chemoradiotherapy in patients with non-surgically resectable non-small cell lung cancer

作　　者：于青 胡永强[1] 刘月娟[1] Yu Qing;Hu Yongqiang;Liu Yuejuan(Department of Radiotherapy,Puyang People′s Hospital,Puyang 457000,China)

机构地区：[1]濮阳市人民医院放疗科,濮阳457000

出　　处：《实用医技杂志》2024年第5期332-336,共5页Journal of Practical Medical Techniques

摘　　要：目的对不可手术切除非小细胞肺癌患者分别实施序贯放化疗与同步放化疗,比较2种治疗方案的临床效果。方法此次研究的观察对象为80例不可手术切除非小细胞肺癌患者,入院就诊时间均为2020年1月至2022年8月,按随机数字表法将80例患者分为对照组(40例)、观察组(40例),前者的治疗方案是序贯放化疗,后者的治疗方案是同步放化疗,比较2组的治疗前、治疗后的血清肿瘤标志物水平,并通过病灶大小对2组患者的近期疗效进行评估,同时记录在治疗过程中两组的毒性反应发生情况。结果放化疗后,观察组的血清肿瘤标志物[糖类抗原125(CA125):(38.9±3.4)U/ml与(42.1±6.7)U/ml,t=2.982,P=0.004;鳞状上皮细胞癌抗原(SCC-Ag):(0.31±0.081)ng/ml与(0.38±0.12)ng/ml,t=2.914,P=0.005;细胞角质蛋白19片段抗原21-1(CYFRA21-1)(20.2±3.2)ng/ml与(17.0±1.6)ng/ml,t=2.430,P=0.017]水平均低于对照组;观察组的疾病缓解率、控制率分别为75.0%(30/40)、95.0%(38/40),对照组分别为50.0%(20/40)、77.5%(31/40),2组相比差异有统计学意义(χ^(2)=4.381,P=0.036;χ^(2)=5.165,P=0.023);观察组的毒性反应略高于对照组,但2组的放射性食管炎、胃肠道反应、放射性肺炎、骨髓抑制的发生情况均差异无统计学意义(P>0.05)。结论同步放化疗对不可手术切除非小细胞肺癌患者血清肿瘤标志物水平的控制效果优于序贯放化疗,且同步放化疗能提升患者的近期疗效,不会增加毒性反应。Objective Sequential chemoradiotherapy and synchronous chemoradiotherapy were administered to patients with non-surgically resectable non-small cell lung cancer to compare the clinical effects of the two treatment regimens.Methods The subjects of this study were 80 patients with non-surgically resectable non-small cell lung cancer,who were admitted to the hospital from January 2020 to August 2022.The 80 patients were divided into a control group with 40 cases and an observation group according to the method of numerical tables,and the treatment plan of the former was sequential chemoradiotherapy and that of the latter was synchronous chemoradiotherapy.The levels of serum tumor markers were compared between the two groups before and after the treatment,and the near-term therapeutic efficacy of the patients of the two groups was evaluated by the size of the lesions,and the incidence of toxic reactions of the two groups was also recorded in the course of the treatment.Results After radiotherapy,the levels of serum tumor markers[glycan antigen 125(CA125):(38.9±3.4)U/ml vs(42.1±6.7)U/ml,t=2.982,P=0.004;squamous epithelial cell carcinoma antigen(SCC-Ag):(0.31±0.081)ng/ml vs(0.38±0.12)ng/ml,t=2.914,P=0.005;cytokeratin 19 fragment antigen 21-1(CYFRA21-1)(20.2±3.2)ng/ml vs(17.0±1.6)ng/ml,t=2.430,P=0.017]of the observation group were lower than those of the control group(P<0.05).the disease remission rate and control rate of the observation group were 75.0%(30/40)and 95.0%(38/40),respectively,while those of the control group were 50.0%(20/40)and 77.5%(31/40),respectively,and the difference between the two groups was significant(χ^(2)=4.381,P=0.036;χ^(2)=5.165,P=0.023).Toxic reactions in the observation group were slightly higher than those in the control group,but there was no significant difference in the occurrence of radiation esophagitis,gastrointestinal reactions,radiation pneumonitis,and bone marrow suppression between the two groups(P>0.05).Conclusion Synchronous chemoradiotherapy is more effective than sequ

关 键 词：序贯放化疗 同步放化疗 非小细胞肺癌 血清肿瘤标志物 近期疗效 毒性反应 

分 类 号：R734.2[医药卫生—肿瘤]