同步推量调强放疗治疗肺癌脑转移瘤的有效性及安全性  

Efficacy and safety of simultaneous integrated boost intensity-modulated radiotherapy for the treatment of lung cancer brain metastases

作　　者：杨静[1] 刘方 马玫丽[2] 黄东帅 王军华[2] Yang Jing;Liu Fang;Ma Meili;Huang Dongshuai;Wang Junhua(Department of Tumor Radiation Therapy,Qingdao Municipal Hospital,Qingdao 266011,China;Fourth Department of Oncology,Qingdao Municipal Hospital,Qingdao 266011,China)

机构地区：[1]青岛市市立医院肿瘤放射治疗科,青岛266011 [2]青岛市市立医院肿瘤四科,青岛266011

出　　处：《国际肿瘤学杂志》2024年第10期609-613,共5页Journal of International Oncology

摘　　要：目的分析同步推量调强放疗治疗肺癌脑转移的治疗效果及安全性。方法选取2021年3月—2023年3月青岛市市立医院肿瘤科收治的300例肺癌脑转移瘤患者为研究对象,以随机数字表法分为对照组(n=150)与研究组(n=150)。对照组行序贯三维适形放疗,研究组行同步推量调强放疗;对比两组近、中期疗效,靶区剂量及不良反应发生情况。结果研究组近、中期总有效率分别为73.33%(110/150)、88.67%(133/150),较对照组的51.33%(77/150)、71.33%(107/150)均更高(χ^(2)=15.46,P<0.001;χ^(2)=14.08,P<0.001)。研究组大体肿瘤计划靶区、全脑临床计划靶区的Dmin分别为(23.78±1.11)、(58.46±0.55)Gy,较对照组的(16.67±1.08)、(53.44±0.74)Gy均更高,差异均有统计学意义(t=56.22,P<0.001;t=66.68,P<0.001);研究组大体肿瘤计划靶区、全脑临床计划靶区的Dmean分别为(44.12±0.87)、(62.19±0.57)Gy,较对照组的(37.55±0.89)、(57.78±0.82)Gy均更高,差异均有统计学意义(t=64.65,P<0.001;t=54.08,P<0.001)。研究组不良反应总发生率为30.67%(46/150),对照组为36.67%(55/150),差异无统计学意义(χ^(2)=1.20,P=0.271)。结论肺癌脑转移瘤患者应用同步推量调强放疗,相较于序贯三维适形放疗,近、中期疗效更好,可增加靶区剂量,且不会增加不良反应。Objective To analyze the therapeutic effect and safety of simultaneous integrated boost intensity-modulated radiotherapy for lung cancer brain metastases.Methods A total of 300 patients with lung cancer brain metastases admitted to the Department of Oncology,Qingdao Municipal Hospital from March 2021 to March 2023 were selected as the study objects.The patients were divided into control group(n=150)and study group(n=150)by random number table method.The control group received sequential three-dimensional conformal radiotherapy,while the study group received simultaneous integrated boost intensity-modulated radiotherapy.The short-term and medium-term efficacy,target dose,and adverse reactions were compared between the two groups.Results The short-term and medium-term total effective rates of the study group were 73.33%(110/150)and 88.67%(133/150),respectively,which were higher than those of the control group[51.33%(77/150)and 71.33%(107/150)](χ^(2)=15.46,P<0.001;χ^(2)=14.08,P<0.001).The Dmin in gross tumor planning target volume and whole brain clinical planning target volume of the study group were(23.78±1.11)and(58.46±0.55)Gy,respectively,which were higher than those in the control group[(16.67±1.08)and(53.44±0.74)Gy],with statistically significant differences(t=56.22,P<0.001;t=66.68,P<0.001).The Dmean in gross tumor planning target volume and whole brain clinical planning target volume of the study group were(44.12±0.87)and(62.19±0.57)Gy,respectively,which were higher than those in the control group[(37.55±0.89)and(57.78±0.82)Gy],with statistically significant differences(t=64.65,P<0.001;t=54.08,P<0.001).The total incidence of adverse reactions was 30.67%(46/150)in the study group and 36.67%(55/150)in the control group,with no significantly significant difference(χ^(2)=1.20,P=0.271).Conclusion Compared with sequential three-dimensional conformal radiotherapy,simultaneous integrated boost intensitymodulated radiotherapy has better short-term and medium-term efficacy in patients with lung cancer brain

关 键 词：肺肿瘤 放射疗法 调强适形 脑转移 

分 类 号：R734.2[医药卫生—肿瘤]