论文部分内容阅读
目的:探讨“及时与多次”缩野技术放疗小细胞肺癌,预防放射性肺炎的临床应用价值。方法:2012年1月~2014年1月,随机采集52例小细胞肺癌患者进入研究,剂量分割为2Gy/次,5次/周,总剂量为60Gy,分别于放疗前、放疗30Gy后和放疗50Gy后予以三次CT定位,根据三次定位的CT图像分别制定TPS计划plan1、plan2、plan3。比较前后三次TPS计划的大体肿瘤体积(gross tumor volume,GTV)、V5、V10、V15、V20、V25、V30剂量体积参数的变化,对结果采用SPSS15.0统计软件进行配对t检验。结果:plan2与plan1比较GTV缩小42.2%±24.7%,两者差异有统计学意义(P<0.05);plan3与plan2比较GTV缩小29.2%±11.6%,两者差异有统计学意义(P<0.05);对plan2和plan1双肺Vdose参数分别进行配对t检验,差异有统计学意义(P<0.05);对plan2和plan3双肺的Vdose参数分别进行配对t检验,其中V5、V10、V15、V20差异有统计学意义(P<0.05)。CR 82.7%(43/52),PR 15.4%(8/52),SD1.9%(1/52),有效率98.1%,临床获益率100%。5例患者放疗后1~3个月出现1~2级放射性肺炎,RP发生率为11.5%。结论:小细胞肺癌放射治疗过程中,分别于30Gy、50Gy及时缩野有可能降低放射性肺炎的发生率。
Objective: To investigate the clinical value of “timely and multiple” shrinkage therapy in the treatment of small cell lung cancer and prevention of radiation pneumonitis. Methods: From January 2012 to January 2014, 52 patients with small cell lung cancer were enrolled in the study randomly. The dose was divided into 2Gy / time, 5 times / week, and the total dose was 60Gy. Before radiation, 30Gy and 30Gy respectively, CTG was performed three times after 50Gy, and TPS plans plan1, plan2 and plan3 were made respectively according to CT images of three positions. The changes of volumetric parameters of gross tumor volume (GTV), V5, V10, V15, V20, V25 and V30 were compared between the three TPS plans and the results were analyzed using the SPSS15.0 statistical software. Results: Compared with plan1, the reduction of GTV was 42.2% ± 24.7% in plan2 compared with that of plan1, the difference was statistically significant (P <0.05); compared with plan2, plan3 was 29.2% ± 11.6%, the difference was statistically significant (P <0.05 ). The Vdose parameters of the two lungs of plan 2 and plan 1 were paired t-test respectively, with significant difference (P <0.05). The Vdose parameters of plan 2 and plan 3 lungs were paired t-test respectively. V5, V10, V15 and V20 The difference was statistically significant (P <0.05). CR 82.7% (43/52), PR 15.4% (8/52), SD1.9% (1/52), the effective rate was 98.1%, and the clinical benefit rate was 100%. Five patients had grade 1 or 2 radiation pneumonitis 1 to 3 months after radiotherapy and the incidence of RP was 11.5%. Conclusion: Radiation pneumonitis is likely to be reduced at 30Gy and 50Gy respectively in time for radiotherapy of small cell lung cancer.