SBRT联合化疗治疗老年非小细胞肺癌的临床疗效

目的 研究体部立体定向放射治疗(SBRT)联合化疗治疗老年非小细胞肺癌(NSCLC)的临床疗效.方法 选取接受治疗的老年NSCLC患者128例,按照治疗方法的不同分为联合组(n=64)与SBRT组(n=64),SBRT组行SBRT治疗,联合组行SBRT联合化疗治疗.观察两组治疗前后血小板(PLT)、纤维蛋白原(FIB)、D-二聚体(D-D)、CD3+CD4+、CD3+CD8+、CD4+/CD8+水平变化,以及临床疗效与治疗期间不良反应情况.结果 治疗后,两组PLT、FIB、D-D水平均较治疗前降低,联合组PLT、FIB、D-D水平均较SBRT组低,差异均有统计学意义(P﹤0.05).治疗后,两组CD3+CD8+水平较治疗前降低,CD3+CD4+、CD4+/CD8+水平较治疗前升高;联合组CD3+CD8+水平较SBRT组低,CD3+CD4+、CD4+/CD8+水平较SBRT组高,差异均有统计学意义(P﹤0.05).联合组ORR(78.13％)、DCR(92.19％)高于SBRT组ORR(56.25％)、DCR(75.00％),差异均有统计学意义(P﹤0.05).两组各不良反应发生率比较,差异均无统计学意义(P﹥0.05).结论 SBRT联合化疗可有效缓解机体血液高凝状态,解除机体免疫抑制,疗效显著,安全可靠,可临床推荐使用.

Clinical efficacy of SBRT combined with chemotherapy in the treatment of elderly patients with non-small cell lung cancer

Objective To study the clinical efficacy of stereotactic body radiation therapy (SBRT) combined with che-motherapy in the treatment of elderly patients with non-small cell lung cancer (NSCLC). Method 128 cases of elderly patients with NSCLC were included in the study, combined therapy (n=64) or SBRT alone (n=64) were administered, re-spectively. The change of PLT, FIB, D-D, CD3+CD4+, CD3+CD8+, CD4+/CD8+before and after treatment, as well as the clinical efficacy and adverse reactions during therapy were analyzed. Result After treatment, the level of PLT, FIB and D-D were decreased in both groups, and were significantly lower in combined therapy group than that in SBRT group (P<0.05). Besides, the CD3+CD8+were reduced, while CD3+CD4+and CD4+/CD8+were elevated after treatment in all pa-tients, but CD3+CD8+level was lower, and CD3+CD4+, CD4+/CD8+level were higher in combined therapy group as com-pared with that in SBRT group, with statistically significant difference observed (P<0.05). In combined therapy group, the ORR (78.13％), and DCR (92.19％) were higher than those in SBRT group (ORR, 56.25％;DCR, 75.00％), the difference was of statistically significance (P<0.05). As for the incidence of adverse reactions, similar results were observed be-tween the two groups (P>0.05). Conclusion SBRT in combination with chemotherapy can alleviate the hypercoagulable state, and counter the immunosuppression, which is effective, safe and reliable, as well as clinically applicable.