放化疗不同联合模式治疗非小细胞肺癌患者的疗效毒性反应及其预后因素分析

doi:10.3969/j.issn.1006-6233.2022.07.014

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Abstract Objective: To investigate the efficacy,toxic effect and prognostic factors of different combination modalities of radiotherapy and chemotherapy in patients with non-small cell lung cancer. Methods: The 200 patients with pathologically confirmed non-small cell carcinoma were divided into 3 groups using different treatment modes,including 78 patients in the chemotherapy-only group,68 patients in the sequential chemoradiotherapy group and 54 patients in the synchronous chemoradiotherapy group,and the clinical efficacy,toxic effects and prognostic factors of the three groups were analysed. Results: The short-term total effective rates (complete remission + partial remission) of chemotherapy alone group,sequential chemoradiotherapy group,and synchronous chemoradiotherapy group were 39.74% (31/78),73.53% (50/68),81.48% (44/54),respectively. The comparison between sequential chemoradiotherapy group and the chemotherapy alone group,and the comparison between the synchronous chemoradiotherapy group and the chemotherapy alone group,had statistical significance (P<0.05); the mortality rates of the chemotherapy alone group,the sequential chemoradiotherapy group,and the synchronous chemoradiotherapy group were67.95%(53/78),67.65%(46/68),53.70%(29/54),respectively.Median survival times averaged 12 months (95% confidence interval 6.6-17.2),10 months (95% confidence interval 7.0-14),25 months (95% confidence interval 23.1-28.6).The median survival time in the synchronous chemoradiotherapy group was higher than that in the sequential chemoradiotherapy and chemotherapy alone groups,as seen by statistical analysis (P<0.05).There was a difference between the simultaneous chemoradiotherapy group and the chemotherapy alone group by statistical analysis (P<0.05),and the overall survival rates at 1,2 and 3 years for the three groups were different by statistical analysis (P<0.05).The main side effects in the three groups were bone marrow suppression.The rates of grade Ⅲ and Ⅳ leukopenia in the chemotherapy alone,sequential chemoradiotherapy and synchronous chemoradiotherapy groups were 8.97% (7/78),1.47% (1/68) and 12.96% (7/54) respectively,and there was a statistical difference between the sequential chemoradiotherapy group and the chemotherapy alone and synchronous chemoradiotherapy groups (P<0.05).The decrease in grade Ⅲ and Ⅳ haemoglobin in the chemotherapy alone group,sequential chemomradiotherapy group and simultaneous chemoradiotherapy group was 1.28% (1/78),0 (0/68) and 0 (0/54),and there was a difference in the chemotherapy alone group compared with the sequential chemoradiotherapy group by statistical analysis (P<0.05).Grade Ⅲ and Ⅳ gastrointestinal reactions were 8.97% (7/54),1.47% (1/68) and 0 (0/54) in the chemotherapy alone group,sequential chemoradiotherapy group and synchronous chemoradiotherapy group,respectively,and were statistically different in the sequential chemoradiotherapy group compared with the chemotherapy alone group and the sequential chemoradiotherapy group compared with the synchronous chemoradiotherapy group (P<0.05).In the sequential chemoradiotherapy group and synchronous chemoradiotherapy group,7.35% (5/68) and 5.56% (3/54) of grade Ⅱ~Ⅲ radiation lung injury were found respectively,with no difference by statistical analysis (P>0.05).The percentage of grade Ⅱ~Ⅲ radiation esophagitis in the sequential chemoradiotherapy and synchronous chemoradiotherapy groups was 5.88% (4/68) and 11.11% (6/54),respectively,with no difference by statistical analysis (P>0.05).After univariate analysis,age,gender,PS score,clinical stage,cumulative organ count and pre-treatment haemoglobin level (P<0.2) were all multifactorial for small cell carcinoma of the lung.Screening by the ENTER method showed a=0.05 age,PS score and clinical stage were prognostic influencing factors for non-small cell carcinoma. Conclusion: The main factors affecting non-small cell lung cancer are age,PS score,and clinical stage.The clinical stage is directly related to the survival rate of patients.The earlier the stage,the more obvious the median survival time and survival rate; the prognosis of the patient is also crucial and should be given special attention in clinical work.

Key words： Non-small cell lung cancer Radiation therapy Chemotherapy

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2022.07.014 OR http://www.hbyxzzs.cn/EN/Y2022/V28/I7/1118