容积旋转调强放疗对局部晚期非小细胞肺癌患者疾病控制及安全性的影响

宋丽丽

[摘要] 目的 探討容积旋转调强放疗（VMAT）对局部晚期非小细胞肺癌患者疾病控制及安全性的影响。 方法 选择2018年4月至2019年4月我院收治的局部晚期非小细胞肺癌患者97例，按照随机数字表法分为A组（n=49）和B组（n=48）。A组接受VMAT治疗，B组接受静态适形调强放疗（IMRT）治疗，上述治疗基础上两组均同时给予足叶乙苷联合顺铂方案行化疗。比较两组治疗1个月后的疗效以及并发症发生情况。 结果 A组的病情控制率（93.88%）略高于B组（89.58%），但两组组间比较，差异无统计学意义（P>0.05）;两组放射性食管炎及放射性心脏损伤发生率及损伤等级比较，差异无统计学意义（P>0.05）;A组放射性肺炎的发生率（28.57%）低于B组（58.33%）（P<0.05）。 结论 VMAT用于局部晚期非小细胞肺癌患者的治疗中未对疾病的控制率产生影响，且能降低放射性肺炎的发生率，安全有效。

[关键词] 容积旋转;调强放疗;非小细胞肺癌;疾病控制

[中图分类号] R734.2          [文献标识码] B          [文章编号] 1673-9701（2021）06-0100-04

Impacts of volumetric modulated arc therapy on disease control and safety in patients with locally advanced non-small cell lung cancer

SONG Lili

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

[Abstract] Objective To explore the impacts of volumetric modulated arc therapy （VMAT） on disease control and safety in patients with locally advanced non-small cell lung cancer. Methods A total of 97 patients with locally advanced non-small cell lung cancer admitted to our hospital from April 2018 to April 2019 were selected and divided into the group A（n=49） and the group B（n=48） according to the random number table method. The group A was treated with VMAT， while the group B was treated with intensity modulated radiation therapy（IMRT）. On the basis of the above treatment， both groups were given concurrent chemotherapy with etoposide and cisplatin. The therapeutic efficacy and complications of the two groups after 1 month of treatment were observed. Results The disease control rate in the group A was 93.88%， which was slightly higher than 89.58% in the group B， but there was no statistically significant difference between the two groups（P>0.05）. There was no statistically significant difference in the incidence and grade of radiation esophagitis and radiation-induced heart injury between the two groups（P>0.05）.The incidence of radiation pneumonia in the group A was 28.57%， which was lower than 58.33% in the group B（P<0.05）. Conclusion The application of VMAT in the treatment of patients with locally advanced non-small cell lung cancer do not affect the control rate of the disease， and it is safe and effective in reducing the incidence of radiation pneumonia.

[Key words] Volumetric modulated arc therapy; Intensity modulated radiation therapy; Non-small cell lung cancer; Disease control

IMRT是指辐射视野内剂量的强度按照一定的要求进行调节，继而提高肺癌的治疗效果并降低放疗后损伤[19-20]。IMRT在靶区精准度及使用剂量的平衡性得到有效的提高，但由于部分肺组织仍暴露在放射范围内导致放射性肺炎的发生率与损伤等级相对较高[21-22]。而VMAT作为近年来较为新颖的放射治疗技术，其可通过调整射线强度，使靶区各处的剂量相等且能够根据治疗的需要调节照射体积内的剂量，最大程度上保证周围正常组织以及器官受到的照射剂量最小[23-25]。

本研究显示，A组的病情控制率略高于B组，但组间比较差异无统计学意义。提示VMAT应用于局部晚期非小细胞肺癌患者的治疗中拥有较高的病情控制率。分析其原……