| Objective To analyze the clinical value of intensity-modulated radiotherapy（IMRT） and simultaneous intensitymodulated radiotherapy（SIB-SBRT） in the treatment of massive advanced non-small cell lung cancer（NSCLC）. Methods The clinical data of 60 patients with advanced non-small cell lung cancer whose tumor diameter was more than 5 cm and who received radiotherapy from January 2022 to December 2024 in Changzhou Cancer Hospital were retrospectively analyzed. Among them, the patients who received IMRT were IMRT group（n=27） and those who received SIB-SBRT treatment were SIB-SBRT group（n=33）. The planned target area（PTV）, gross tumor volume（GTVboost）, uniformity index（HI）, conformability index（CI）, target coverage（TC）, biological effect doses of PTV and GTVboost（PTVBED, GTVboost-BED）, maximum dose of spinal cord, V5, V20, V30, bilateral lungs were compared between the two groups. Results Compared with IMRT group, the index of GTVboost in SIB-SBRT group increased, and the difference was statistically significant（P< 0.05）. Compared with TC in two groups, the difference was not statistically significant（P> 0.05）. CI and HI in SIB-SBRT group were lower than those in IMRT group, with no statistical significance（P> 0.05）. Compared with IMRT group, the index of GTVboost-BED in SIB-SBRT group increased, and the difference was statistically significant（P< 0.05）. Compared with IMRT group, the maximum dose of spinal cord, V5 of both lungs, average dose of both lungs and average dose of heart in SIB-SBRT group decreased, and the difference was statistically significant（P< 0.05）. Conclusion For patients with advanced NSCLC with tumor diameter>5 cm, SIB-SBRT can significantly increase the dose in GTVboost region and biological effect dose, and has obvious advantages in reducing the radiation dose in normal tissues（especially the average dose in lung V5 and heart）. |
