大剂量和常规分割剂量调强适形放疗联合89SrCl2静脉注射治疗肺癌骨转移的效果-《中国医学物理学杂志》

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Title:: Curative effects of high-dose and routine fractionated intensity-modulated radiotherapy separately combined with 89SrCl2 intravenous injection on bone metastasis of lung cancer

文章编号:: 1005-202X（2020）09-1111-04

作者:: 郭连洪1; 赵素花2; 李斌3; 於雪清1; 段丽莎4; 1. 张家口市第一医院核医学科，河北张家口075000；2. 张家口市第一医院透析科，河北张家口075000；3. 张家口市第一医院骨科，河北张家口075000；4. 河北医科大学第三医院放射科，河北石家庄050051

Author(s):: GUO Lianhong1; ZHAO Suhua2; LI Bin3; YU Xueqing1; DUAN Lisha4; 1. Department of Nuclear Medicine，the First Hospital of Zhangjiakou City, Zhangjiakou 075000, China 2. Department of Dialysis, the First Hospital of Zhangjiakou City, Zhangjiakou 075000, China 3. Department of Orthopaedics, the First Hospital of Zhangjiakou City, Zhangjiakou 075000, China 4. Department of Radiology, the Third Hospital of Hebei Medical University, Shijiazhuang 050051, China

关键词:: 大剂量调强适形放疗; 常规分割剂量调强适形放疗; 氯化锶; 静脉注射; 肺癌; 骨转移; 疼痛

Keywords:: high-dose intensity-modulated radiotherapy routine fractionated intensity-modulated radiotherapy 89SrCl2 intravenous injection lung cancer bone metastasis pain

分类号:: R816.8

DOI:: 10.3969/j.issn.1005-202X.2020.09.006

文献标志码:: A

摘要:: 目的：分析大剂量和常规分割剂量调强适形放疗分别联合89SrCl2静脉注射治疗肺癌骨转移的效果，为骨转移的临床治疗提供试验数据。方法：将80例肺癌骨转移患者按自愿原则分大剂量调强适形放疗组（A组, n=35）和常规分割剂量调强适形放疗组（B组, n=45）。比较两组近期疗效、远期疗效、疼痛及不良反应发生情况。结果：（1）两组近期疗效等级比较差异无统计学意义（P>0.05），A组局部控制率略高于B组（91.43% vs 84.44%），但差异无统计学意义（P>0.05）；（2）A组累积生存率为84.00%，高于B组的66.50%，差异无统计学意义（P>0.05）；（3）治疗后两组NRS评分均较治疗前下降，但A 组治疗后NRS评分低于B组，且疼痛缓解开始时间较B组短，差异有统计学意义（P<0.05）；（4）两组白细胞减少、血小板减少、消化道副反应、神经毒性、放射性皮肤损伤等Ⅲ~Ⅳ级不良反应发生率比较差异无统计学意义（P>0.05）。结论：大剂量或常规分割剂量调强适形放疗联合89SrCl2静脉注射治疗肺癌骨转移在近远期疗效上获益相当，但前者对疼痛的改善更显著更迅速，且大剂量调强适形放疗并未增加Ⅲ~Ⅳ级不良反应发生率。

Abstract:: Objective To provide experimental data for clinical treatment of bone metastases by analyzing the curative effects of high-dose and routine fractionated intensity-modulated radiotherapy (IMRT) separately combined with 89SrCl2 intravenous injection on bone metastasis of lung cancer. Methods Eighty patients with bone metastases of lung cancer were divided into high-dose IMRT group (group A, n=35) and routine fractionated IMRT group (group B, n=45). The short-term and long-term curative effects, pain and occurrence of adverse reactions were compared between two groups. Results (1) There was no significant difference in short-term curative effect between two groups (P>0.05). The tumor control probability in group A was slightly higher than that in group B，without statistical differences (91.43% vs 84.44%, P>0.05). (2) The cumulative survival rate of group A was 84.00%, higher than 66.50% of group B, without statistical differences (P>0.05). (3) After treatment, the NRS scores in both groups were decreased. However, the NRS score of group A was lower than that of group B, and the starting time of pain relief was shorter than that of group B (P<0.05). (4)There was no significant difference between two groups in the incidence of grade III-IV adverse reactions such as leukopenia, thrombocytopenia, gastrointestinal side effects, neurotoxicity and radiation-induced skin injuries (P>0.05). Conclusion The short-term and long-term curative effects of high-dose and routine fractionated IMRT separately combined with 89SrCl2 intravenous injection are comparable on bone metastasis of lung cancer. However, the pain relief of the former is more significant and faster. Moreover, compared with routine fractionated IMRT, high-dose IMRT does not increase the incidence of grade III-IV adverse reactions.

《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

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