【摘要】 目的观察调强放射治疗(IMRT)与容积调强放射治疗(VMAT)技术治疗小细胞肺癌合并上腔静脉压迫综合征(SVCS)的临床效果。方法回顾性分析2010年1月至2016年1月石家庄市第一医院收治的48例小细胞肺癌合并SVCS患者的病历资料,依据不同放射治疗方案分为IMRT组(23例)和VMAT组(25例)。分析2组患者放射治疗的近期疗效,随访观察2组患者的生存情况。结果 IMRT组和VMAT组放射治疗结束后症状缓解率分别为91.3%(21/23)和92.0%(23/25),差异无统计学意义(P=0.663)。IMRT组和VMAT组治疗后客观有效率分别为82.6%(19/23)和84.0%(21/25),差异无统计学意义(P=0.600)。IMRT组和VMAT组局部控制率分别为69.6%(16/23)和84.0%(21/25),差异无统计学意义(P=0.199)。IMRT组、VMAT组放射治疗结束后半年、1年、2年生存率分别为69.2%比72.0%、21.7%比32.0%、4.3%比8.0%,二者之间差异均无统计学意义(P=0.881、0.612、0.648)。结论小细胞肺癌合并SVCS患者应用IMRT及VMAT近期疗效比较无明显差异,均是放射治疗的优选治疗方式,但具体临床数据上VMAT略优于IMRT,而且VMAT具有更高的局部控制率。更多还原

【Abstract】 Objective To observe the effect of intensity-modulated radiation therapy(IMRT) and volumetric intensity-modulated arc therapy( VMAT) on small cell lung cancer with superior vena cava syndrome(SCVS).Methods Clinical records of 48 cases of small cell lung cancer with SCVS in the First Hospital of Shijiazhuang from January 2010 to January 2016 were reviewed; 23 patients were treated with IMRT and 25 patients were treated with VMAT.Short-term curative effect of radiotherapy and survival condition of patients were analyzed.Results Symptom remission rates in IMRT group and VMAT group were 91.3%(21/23) and 92.0%(23/25)(P=0.548).Effective rates of radiotherapy in IMRT group and VMAT group were 82.6%(19/23) and 84.0%(21/25)(P =0.600).Local control rates in IMRT group and VMAT group were 69.6%(16/23) and 84.0%(21/25)(P=0.199).The 6-month, 1- and 2-year survival rates in IMRT group and VMAT group were 69.2% vs 72.0%, 21.7% vs 32.0%, 4.3% vs 8.0%(P = 0.881,0.612, 0.648).Conclusions Short-term therapeutic effects of IMRT and VMAT show no significant differences on small cell lung cancer patients with SCVC.VMAT shows a higher local control effect.更多还原