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目的探析老年晚期非小细胞肺癌行短疗程大分割放疗方案治疗的临床近期疗效和生存影响因素。方法回顾性分析2013-06-2015-01期间我院收治的79例晚期非小细胞肺癌患者的临床资料。按照治疗方案的不同分为对照组和观察组,其中对照组38例,观察组41例。对照组所有患者均接受常规放化疗方案治疗;观察组采用短疗程,影像引导下大分割三维适形放疗联合常规化疗的方案。观察研究对象的临床近期疗效和不良反应,单因素分析和多因素分析影响患者生存的因素。结果经治疗后,观察组CR率、PR率分别为12.2%、19.5%,显著高于对照组,P<0.05;两组在接受治疗过程中均未出现3~4级不良反应,且出现的不良反应在接受对症治疗后均得到缓解,P>0.05。单因素分析显示,PTR前KPS评分>70、PTR后化疗≥4个疗程是影响生存的重要因素;多因素分析显示,PTR前KPS评分>70是影响生存的独立危险因素。结论老年晚期非小细胞肺癌患者接受短疗程、大分割三维适形放疗方案治疗时,临床疗效显著且有较高的安全性。KPS评分越高,接受化疗的时间越短,患者的生存时间就越长。
Objective To investigate the short-term treatment of elderly patients with non-small cell lung cancer radiotherapy program of short-term efficacy and survival factors. Methods The clinical data of 79 patients with advanced non-small cell lung cancer admitted to our hospital from 2013-06-2015-01 were retrospectively analyzed. In accordance with the different treatment programs were divided into control group and observation group, 38 cases in the control group and 41 cases in the observation group. All patients in the control group were treated with conventional radiotherapy and chemotherapy regimen; the observation group was treated with short course and video-guided large-scale three-dimensional conformal radiotherapy combined with conventional chemotherapy. Observed the clinical short-term efficacy and adverse reactions, univariate analysis and multivariate analysis of factors affecting the survival of patients. Results After treatment, CR rate and PR rate in the observation group were 12.2% and 19.5%, respectively, which were significantly higher than those in the control group (P <0.05). No grade 3 or 4 adverse reactions were observed in the two groups Adverse reactions were relieved after symptomatic treatment, P> 0.05. Univariate analysis showed that pre-PTR KPS score> 70, PTR chemotherapy after 4 courses of treatment is an important factor affecting survival; Multivariate analysis showed that pre-PTR KPS score> 70 is an independent risk factor for survival. Conclusion The treatment of elderly patients with advanced non-small cell lung cancer receiving short-course and large-scale three-dimensional conformal radiotherapy has significant clinical effect and high safety. The higher the KPS score, the shorter the time for chemotherapy and the longer the patient’s survival.