大分割放疗联合EP方案化疗治疗局限期小细胞肺癌的临床疗效及安全性

何宜生; 鲍亮亮; 余嘉文; 吕杨

doi:10.3971/j.issn.1000-8578.2023.22.0848

大分割放疗联合EP方案化疗治疗局限期小细胞肺癌的临床疗效及安全性

Clinical Efficiency and Safety of Hypofractionated Thoracic Radiotherapy Combined with EP Chemotherapy on Patients with Limited-stage Small-cell Lung Cancer

摘要

摘要:
目的探讨大分割放疗模式联合EP方案化疗治疗局限期小细胞肺癌（LS-SCLC）的疗效及安全性。
方法以117例LS-SCLC患者为研究对象，随机分为试验组（59例）和对照组（58例）。试验组患者给予大分割放疗联用EP方案化疗，对照组给予超分割放疗方案联用EP方案化疗。比较两组患者近期客观缓解率（ORR）、2年总生存率（OS）、2年无进展生存期（PFS）和免疫细胞水平；比较两组患者不良反应发生率。
结果治疗后试验组患者近期ORR高于对照组，但差异无统计学意义（P > 0.05）；平均OS、PFS显著长于对照组（均P < 0.05）；CD3⁺、CD4⁺、CD4⁺/CD8⁺以及NK细胞水平显著高于对照组，CD8+水平显著低于对照组（P < 0.05）；放射性肺炎、放射性食管炎、重度皮炎发生率明显低于对照组（P < 0.05）。
结论大分割放疗联合EP化疗可提高局限期小细胞肺癌疗效，提高患者生存期，降低机体免疫功能损害，减轻放疗不良反应。

Abstract:
Objective To investigate the efficacy and safety of hypofractionated thoracic radiotherapy combined with EP chemotherapy in the treatment of limited-stage small-cell lung cancer (LS-SCLC).
Methods A total of 117 patients with LS-SCLC were enrolled and randomly divided into test group (n=59) and control group (n=58). Patients in the experiment group were given hypofractionated thoracic radiotherapy combined with EP chemotherapy, while patients in the control group were given hyperfractionation radiotherapy combined with EP chemotherapy. Objective response rate (ORR), 2-year overall survival (OS), 2-year progression free survival (PFS), and immune cell level were used to evaluate clinical efficacy. We compared the incidence of side effects between the two groups.
Results After the treatment, the ORR of patients in the test group was higher than that in the control group (P > 0.05). The mean OS and PFS of patients in the test group were significantly longer than those in the control group (P < 0.05). The levels of CD3⁺, CD4⁺, CD4⁺/CD8⁺, and NK cells in the test group were significantly higher, whereas the levels of CD8⁺ were significantly lower than those in the control group (P < 0.05). The incidence of radiation pneumonitis, radiation esophagitis, and severe dermatitis in the test group was significantly lower than that in the control group (P < 0.05).
Conclusion Hypofractionated radiotherapy combined with EP chemotherapy for treatment of LS-SCLC can effectively improve the anticancer efficacy and patient survival, reduce the damage to the body's immune function, and alleviate adverse reaction of radiotherapy.

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