同步推量调强放疗联合多西他赛同期化疗治疗晚期非小细胞肺癌的临床效果及短期预后观察

目的探讨同步推量调强放疗(simultaneous integrated boost intensity-modulated radiation therapy,SIB-IMRT)联合多西他赛同期化疗治疗晚期非小细胞肺癌(non small cell lung cancer,NSCLC)的临床效果及短期预后。方法选取2017年1月—2018年4月收治的87例晚期NSCLC,根据放疗方式的不同,分为观察组(n=43)和对照组(n=44)。观察组采用SIB-IMRT联合多西他赛同期化疗,对照组采用常规调强放疗联合多西他赛同期化疗,均治疗6周。比较两组治疗后临床疗效、治疗期间不良反应发生情况及短期预后情况。结果两组均随访至2019年6月或患者死亡,随访率100%。观察组治疗总有效率显著高于对照组,比较差异有统计学意义(χ2=3.149,P=0.039)。观察组局部控制率和生存率均高于对照组,无疾病进展生存时间长于对照组,差异有统计学意义(P<0.05或P<0.01)。两组不良反应发生情况比较差异无统计学意义(P>0.05)。结论SIB-IMRT联合多西他赛同期化疗治疗晚期NSCLC的临床效果显著,提高了局部控制率和生存率,延长了无疾病进展生存时间,并且未明显增加不良反应,安全性较好。

Clinical Effect and Short-term Prognosis of Simultaneous Integrated Boost Intensity Modulated Radiotherapy Combined with Docetaxel in the Treatment of Advanced Non-small Cell Lung Cancer

Objective To investigate the clinical effect and short-term prognosis of simultaneous integrated boost intensity-modulated radiation therapy(SIB-IMRT)combined with docetaxel in the treatment of advanced non small cell lung cancer(NSCLC).Methods Eighty-seven cases of advanced NSCLC that were treated from January 2017 to April 2018 were selected and divided into observation group(n=43)and control group(n=44)according to different radiotherapy methods.The observation group was treated with SIB-IMRT combined with docetaxel and the control group was treated with conventional intensity-modulated radiotherapy combined with docetaxel.Both groups were treated for six weeks.The clinical effect after treatment,acute adverse reactions during treatment and short-term prognosis of the two groups were compared.Results Both groups were followed up to June 2019 or until death,and the follow-up rate was 100%.The total effective rate of the observation group was significantly higher than that of the control group(χ2=3.149,P=0.039).The local control rate and survival rate of the observation group were higher than those of the control group,and the progression-free survival(PFS)time was longer than that of the control group,suggesting significant differences(P<0.05 or P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion SIB-IMRT combined with docetaxel chemotherapy has a significant clinical effect on advanced NSCLC.It improves the local control rate and survival rate,prolongs the PFS time,and does not significantly increase adverse reactions,with a good safety.