摘要
目的探讨螺旋断层放疗技术对Ⅲ期肺鳞癌患者的治疗效果、生存情况及影响预后的相关因素。方法回顾性收集2013年6月至2019年12月间空军特色医学中心107例Ⅲ期肺鳞癌患者的临床资料。患者均行螺旋断层放疗,GTV总剂量为60~70 Gy,每周5次放疗,每天1次,共15~20次;同步行顺铂化疗或紫杉醇+卡铂序贯化疗。根据实体瘤疗效评价标准RECIST 1.1版评价近期疗效,依据NCI CTC 4.0版分级标准进行不良反应评价。Kaplan-Meier法计算生存率,Log-rank检验比较组间生存差异,预后的多因素分析采用Cox比例风险回归模型。结果107例患者治疗后6个月均可评价疗效,其中完全缓解(CR)17例、部分缓解(PR)46例、稳定(SD)41例和进展(PD)3例,客观有效率(RR)为58.9%,疾病控制率(DCR)为97.2%。不良反应主要包括放射性食管炎3级9例,放射性肺炎3级2例、4级1例。至随访截止时间,全组患者的中位生存时间(OS)为21.5个月,中位无进展生存时间(PFS)为17.5个月,患者1、2、3年生存率分别为82.5%、36.7%、22.3%。Cox多因素分析结果显示,放疗总剂量(OR=2.286,95%CI:1.174~4.452,P=0.015)和近期疗效(OR=0.258,95%CI:0.130~0.513,P<0.001)是影响肺鳞癌患者预后的独立因素。结论螺旋断层放疗联合同步或序贯化疗治疗Ⅲ期肺鳞癌的近期疗效显著,患者生存期延长,且不良反应发生率较低。
Objective To investigate the therapeutic effect,survival and prognostic factors of patients with stageⅢsquamous cell lung cancer treated by helical tomography.Methods The clinical data of patients with stageⅢsquamous cell lung cancer treated by helical tomography from June 2013 to December 2019 in Air Force Medical Center were collected retrospectively.GTV total dose was 60-70 Gy,5 times a week,1 time a day,15-20 times in total.Concurrent chemotherapy with cisplatin or paclitaxel and carboplatin sequential chemotherapy were administered.The efficacy was evaluated according to Response Evaluation Criteria in Solid Tumors(RECIST)1.1,and the adverse reactions were evaluated according to Common Terminology Criteria for Adverse Events version 4.0.The survival rate was calculated by Kaplan-Meier method and the survival curve was drawn.The survival difference between the two groups was compared by Log-rank test,and the multivariate analysis of survival was analyzed by Cox proportional risk regression model.Results A total of 107 cases could be evaluated 6 months after treatment.Complete response(CR)was found in 17 cases,partial response(PR)in 46 cases,stable disease(SD)in 41 cases and progression disease(PD)in 3 cases.The response rate(RR)was 58.9%,and the disease control rate(DCR)was 97.2%.The main side effects included 9 cases of grade 3 radiation esophagitis,2 cases of grade 3 radiation pneumonia and 1 case of grade 4 radiation pneumonia.The median survival time(OS)was 21.5 months and the median progression-free survival time(PFS)was 17.5 months.The 1-,2-and 3-year survival rates were 82.5%,36.7%and 22.3%,respectively.Cox multivariate analysis showed that total prescription dose(OR=2.286,95%CI:1.174-4.452,P=0.015)and short-term efficacy(OR=0.258,95%CI:0.130-0.513,P<0.001)were independent prognostic factors for patients with lung squamous cell carcinoma.Conclusion Helical tomotherapy combined with synchronous or sequential chemotherapy in the treatment of stageⅢlung squamous cell carcinoma has obvious short-term efficacy,prolonged survival time and low incidence of adverse reactions.
作者
刘志飞
任刚
康晓黎
王颖杰
LIU Zhifei;REN Gang;KANG Xiaoli;WANG Yingjie(Graduate School of Hebei North University, Zhangjiakou 075000, China)
出处
《临床肿瘤学杂志》
CAS
北大核心
2020年第8期738-743,共6页
Chinese Clinical Oncology
关键词
肺鳞癌
螺旋断层放疗
生存
预后因素
Squamous cell lung cancer
Helical tomotherapy
Survival
Prognostic factors
作者简介
通讯作者:王颖杰,E-mail:wangyj9999@163.com。
