三维适形放疗同步吉非替尼化疗治疗局部晚期肺腺癌的疗效

宋丽丽

[摘要] 目的 探討局部晚期肺腺癌应用三维适形放疗同步吉非替尼化疗治疗的效果。 方法 选择2019年1月至2020年1月我院收治的晚期肺腺癌患者76例，按照随机数字表法分为两组，每组各38例。对照组实施三维适形放疗，观察组在此基础上同步吉非替尼化疗，比较两组的治疗效果、细胞因子水平[白细胞介素2（IL-2）、肿瘤坏死因子-α（TNF-α）、集落刺激因子（CSF）]及不良反应发生情况。 结果 观察组疾病控制率（DCR）、总有效率（RR）分别为97.37%、81.58%，均高于对照组的78.95%、52.63%，差异有统计学意义（P<0.05）;与对照组相比，观察组治疗2个月后IL-2、CSF水平较高，TNF-α水平较低，且两组治疗后均优于治疗前，差异有统计学意义（P<0.05）;观察组不良反应总发生率为21.05%，低于对照组的34.21%，但差异无统计学意义（P>0.05）。 结论 局部晚期肺腺癌应用三维适形放疗同步吉非替尼化疗治疗的效果较好，安全性较高。

[关键词] 肺腺癌;吉非替尼化疗;三维适形放疗;细胞因子水平;不良反应

[中图分类号] R734.2          [文献标识码] B          [文章编号] 1673-9701（2021）04-0072-03

The efficacy of three-dimensional conformal radiotherapy combined with gefitinib chemotherapy for locally advanced lung adenocarcinoma

SONG Lili

Department Ⅴ of Oncology， Jiamusi Tumor Hospital in Heilongjiang Province， Jiamusi   154002， China

[Abstract] Objective To investigate the efficacy of three-dimensional conformal radiotherapy combined with gefitinib chemotherapy for locally advanced lung adenocarcinoma. Methods A total of 76 patients with advanced lung adenocarcinoma admitted to our hospital from January 2019 to January 2020 were selected and divided into the observation group（n=38） and the control group （n=38） according to the random number table method. The control group was treated with three-dimensional conformal radiotherapy， while the observation group was treated with gefitinib chemotherapy on the above basis simultaneously. The therapeutic efficacy， cytokine levels （interleukin-2[IL-2]， tumor necrosis factor-α [TNF-α]， colony stimulating factor [CSF]） and adverse reactions （ADRs） were compared between the two groups. Results The disease control rate （DCR） and overall response rate （RR） in the observation group were 97.37% and 81.58%， which were higher than 78.95% and 52.63% in the control group respectively， with statistically significant differences （P<0.05）. Compared with the control group， the levels of IL-2 and CSF in the observation group were higher and the level of TNF-α was lower at 2 months after treatment， and both groups were better than those before treatment， with statistically significant differences（P<0.05）. The total incidence of ADRs in the observation group was 21.05%， which was slightly lower than 34.21% in the control group， but the differences were not statistically significant（P>0.05）. Conclusion Three-dimensional conformal radiotherapy combined with gefitinib chemotherapy is safe and effective for locally advanced lung adenocarcinoma.

[Key words] Lung adenocarcinoma; Gefitinib chemotherapy; Three-dimensional conformal radiotherapy; Cytokine level; Adverse reactions

肺腺癌是严重影响人体健康的疾病，是临床较为常见的肺癌类型，患者早期主要表现为刺激性咳嗽、发热、喘息等症状，临床诊断难度较高，导致多数患者确诊时为中晚期，错失最佳手术治疗时机[1-2]。目前，临床主要采用化疗、放疗等方法治疗晚期肺腺癌，其中作為高精度放射治疗的三维适形放疗，可有效缓解局部病变、降低亚临床转移风险，在肝肿瘤、肺癌、脑肿瘤等多个肿瘤治疗领域中应用较为广泛[3]。吉非替尼作为表皮生长因子受体酪氨酸激酶（Epidermal growth factor receptor tyrosine kinase inhibitors，EGFR-TKI）抑制剂，可加速肿瘤细胞凋亡，阻碍肿瘤血管形成[4]。而随着近年来放疗同步化疗的研究进展，二者协同作用，可作为综合治疗方式为晚期肺癌的治疗提供新的方向。……