同期推量调强放疗与序贯推量调强放疗治疗老年局晚期非小细胞肺癌的效果比较.docVIP

同期推量调强放疗与序贯推量调强放疗治疗老年局晚期非小细胞肺癌的效果比较 　　[摘要] 目的 比较老年局晚期非小细胞肺癌（LA-NSCLC）患者采取同期推量调强放疗（SIB-IMRT）与序贯推量调强放疗（SEQ-IMRT）的效果。 方法 回顾性分析徐州医学院附属医院2010年1月～2014年10月住院的56例老年LA-NSCLC患者，随机分为治疗组（28例，采用SIB-IMRT）和对照组（28例，采用SEQ-IMRT）。比较两组患者放疗计划不同参数的剂量及两组患者的近期疗效和急性毒副反应。 结果 SIB-IMRT组肿瘤靶区内生物等效剂量（BED）（95.3±4.7）Gy高于SEQ-IMRT组的（86.4±3.2）Gy，差异有统计学意义（P0.05）；两组靶区肺受照相关体积、肺平均受照剂量、脊髓受照最大剂量、心脏受照相关体积比较，差异无统计学意义（P0.05）。治疗组总有效率（CR+PR）为82.1%，对照组总有效率为46.4%，两组比较差异有统计学意义（P0.05）。 结论 SIB-IMRT与SEQ-IMRT治疗老年LA-NSCLC，前者可获得理想的剂量分布，可提高肿瘤靶区内的BED且未增加周围危及器官剂量，可提高近期疗效且急性毒副反应无增加。 　　[关键词] 非小细胞肺癌；放射治疗；调强放疗；剂量学 　　[中图分类号] R734.2 [文献标识码] A [文章编号] 1674-4721（2015）09（b）-0042-04 　　Effect comparison of SIB-IMRT and SEQ-IMRT for the treatment of elderly patients with locally advanced non-small cell lung cancer 　　WU Yang1 LI Liang1 YU Hong-min2 　　1.Department of Radiotherapy，Affiliated Hospital of Xuzhou Medical College，Xuzhou 221002，China；2.Public Health of Xuzhou Medical College School，Xuzhou 221004，China 　　[Abstract] Objective To compare the radiotherapy effect between SIB-IMRT and SEQ-IMRT in treating elderly patients with locally advanced non-small cell lung cancer （LA-NSCLC）. Methods 56 Patients with LA-NSCLC from January 2010 to October 2014 in our hospital were retrospectively analyzed.Patients were randomly divided into treatment group （n=28） and control group （n=28）.The control group were given SEQ-IMRT and the treatment group were given SIB-IMRT.Then the dosimetry of different parameters in radiotherapy plans，efficacy and acute toxicities between two groups was compared respectively. Results The BED of tumor target zone in treatment group was （95.3±4.7）Gy，significantly higher than that of （86.4±3.2）Gy in control group，and the difference was statistically significant（P0.05）.There were no statistically significant between two groups in target illuminated lung volume，mean lung dose，the maximum dose of spinal cord illuminated and heart illuminated volume（P0.05）.The total efficacy rate was 82.1% in treatment group an