立体定向放疗与全脑放疗对肺癌脑转移瘤近期疗效的影响  

Effects of stereotactic radiotherapy and whole brain radiotherapy on short-term efficacy in lung cancer with brain metastases

作　　者：刘永志 王红旗 LIU Yong-zhi;WANG Hong-qi(Department of Radiotherapy,General Hospital of Pingmei Shenma Medical Group,Pingdingshan,Henan 467000,China)

机构地区：[1]平煤神马医疗集团总医院放疗科,河南平顶山467000

出　　处：《医药论坛杂志》2024年第13期1414-1418,1425,共6页Journal of Medical Forum

摘　　要：目的分析立体定向放疗(stereotactic radiotherapy,SRT)与全脑放疗(whole brain radiotherapy,WBRT)对肺癌脑转移瘤近期疗效及疼痛、血清基质金属蛋白酶-9(MMP-9)、胰岛素样生长因子-1(IGF-1)及神经认知功能的影响。方法选取2020年12月—2022年12月平煤神马医疗集团总医院收治的肺癌脑转移瘤患者81例,按照治疗方式不同分为SRT组(n=40)和WBRT组(n=41)。SRT组采用SRT治疗,WBRT组采用WBRT治疗。比较两组近期疗效、放疗前和放疗后NRS评分、血清MMP-9、IGF-1水平,并比较放疗前、放疗后及放疗后3个月两组神经认知功能、生活质量。结果SRT组客观缓解率高于WBRT组(P<0.05),两组疾病控制率比较,差异无统计学意义(P>0.05);放疗后,两组NRS评分和血清MMP-9、IGF-1水平较放疗前降低(P<0.05),且SRT组低于WBRT组(P<0.05);放疗后及放疗后3个月,SRT组MMSE评分、MoCA评分和QLQ-C30评分较放疗前明显升高(P<0.05),且放疗后3个月高于放疗后(P<0.05),WBRT组与放疗前比较,差异无统计学意义(P>0.05)。结论SRT较WBRT更有利于提高肺癌脑转移瘤患者近期疗效,减轻患者疼痛,并降低血清MMP-9、IGF-1水平,有助于提高患者神经认知功能和生活质量。Objective To analyze the effects of stereotactic radiotherapy(SRT)and whole brain radiotherapy(WBRT)on the short-term efficacy,pain,serum matrix metalloproteinase-9(MMP-9),insulin-like growth factor-1(IGF-1)and neurocognitive function in lung cancer with brain metastases.Methods Totally 81 patients with lung cancer complicated with brain metastases admitted to General Hospital of Pingmei Shenma Medical Group from December 2020 to December 2022 were selected and divided into SRT group(n=40)and WBRT group(n=41)according to different treatment methods.SRT group was treated with SRT,and WBRT group was given WBRT.The short-term efficacy,NRS score and serum MMP-9 and IGF-1 levels before and after radiotherapy and neurocognitive function and quality of life before radiotherapy,after radiotherapy and at 3 months after radiotherapy were compared between the two groups.Results The objective remission rate in SRT group was higher than that in WBRT group(P<0.05),but there was no statistically significant difference in disease control rate between the two groups(P>0.05).After radiotherapy,the NRS score and levels of serum MMP-9 and IGF-1 in the two groups were reduced compared with those before radiotherapy(P<0.05),and the score and levels in SRT group were lower than those in WBRT group(P<0.05).After radiotherapy and at 3 months after radiotherapy,the MMSE score,MoCA score and QLQ-C30 score in SRT group were significantly enhanced compared with those before radiotherapy(P<0.05),and the scores at 3 months after radiotherapy were higher than those after radiotherapy(P<0.05),but there were no statistical differences in WBRT group compared with those before radiotherapy(P>0.05).Conclusion SRT is more beneficial than WBRT to improve the short-term efficacy,relieve the pain,and reduce the levels of serum MMP-9 and IGF-1 in patients with lung cancer and brain metastases,and the former one is more helpful to enhance the neurocognitive function and quality of life of patients.

关 键 词：立体定向放疗 全脑放疗 肺癌 脑转移瘤 疼痛 

分 类 号：R734.2[医药卫生—肿瘤]