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| 静态调强放疗与三维适形放疗对局部晚期非小细胞肺癌的临床疗效比较 |
| Comparison oftherapeutic effect of intensity modulated and three dimensional conformal radiation therapy for local advanced non-small cell lung cancer |
| 投稿时间：2018-03-20 |
| DOI：10.3969/j.issn.1000-0399.2018.08.006 |
| 中文关键词: 静态调强治疗 三维适形放疗 局部晚期非小细胞肺癌 |
| 英文关键词: Intensity modulated radiation therapy Three dimensional conformal radiation therapy Locally advanced non-small cell lung cancer |
| 基金项目:蚌埠医学院课题（项目编号：BYZX201603） |
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| 中文摘要: |
| 目的 比较局部晚期非小细胞肺癌（LANSCLC）静态调强放疗（IMRT）和三维适形放疗（3D-CRT）的临床疗效。方法 回顾性分析2015年10月至2017年6月皖北煤电集团总医院收治的61例LANSCLC患者的临床资料。按治疗方法分为IMRT组（33例）和3D-CRT组（28例）。比较两组患者临床治疗总有效率、放射性损伤发生率、靶区剂量和放疗剂量-体积相关参数。结果 IMRT组的临床治疗总有效率与3D-CRT组比较（91.89%vs 89.29%），差异无统计学意义（P > 0.05）。IMRT组的Ⅲ-Ⅳ级放射性食管炎和Ⅲ-Ⅳ放射性肺炎发生率低于3D-CRT组（6.06%vs 25.00%；3.03%vs 21.43%），差异均有统计学意义（P < 0.05）。两组患者靶区平均剂量差异无统计学意义（P > 0.05），IMRT在靶区的不均匀指数和靶区的适形指数均优于3D-CRT组，差异均有统计学意义（P < 0.05）。IMRT组患肺的V5、V20和V30数值均高于3D-CRT组，差异均有统计学意义（P < 0.05）。结论 IMRT治疗LANSCLC，可获得与3D-CRT相似的临床疗效，IMRT靶区剂量分布优于3D-CRT，放射性损伤发生情况较少，安全性较高，但低剂量区照射体积增大值得注意。 |
| 英文摘要: |
| Objective To compare the therapeutic effect of intensity modulated radiation therapy (IMRT) and three dimensional conformal radiotherapy (3D-CRT) for local advanced non-small cell lung cancer (LANSCLC). Methods Sixty-one patients of LANSCLC in our hospital from Oct 2015 to Dec 2017 were divided into IMRT group (33 cases) and 3D-CRT group (28 cases) according to treatment methods. The clinical effective rate, incidence of acute radiation-induced injury, target section dosage and dosage -volume relevant parameters were compared between the two groups. Results The difference of clinical effective rates in IMRT group and 3D-CRT group (91.89% vs 89.29%) had no statistical significance (P > 0.05). The differences of incidence of Ⅲ-IV radiation-induced esophagitis and Ⅲ-IV radiation-induced pneumonitis in IMRT group and 3D-CRT group (6.06% vs 25.00% and 3.03% vs 21.43%) had statistical significance (P<0.05). The average dose of planning target between the two groups had no statistical significance (P>0.05). But the inhomogeneity index and conformability index in IMRT group were better than that in 3D-CRT group with significant difference (P < 0.05). The V5, V20 and V30 in IMRT group were higher than those in 3D-CRT group with statistical significance (P<0.05). Conclusion IMRT used in LANSCLC, compared with 3D-CRT, has similar therapeutic effect. The target section dosage distribution of IMRT is better than 3D-CRT. Also there is less radiation-induced injury condition in IMRT. However, the irradiation volume of low dosage section of IMRT is larger, which is noteworthy. |
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