李丹明,王 黎,王沛沛.适形调强与容积旋转调强技术对局部晚期非小细胞肺癌临床效果比较[J].中国肿瘤,2016,25(9):742-746.
适形调强与容积旋转调强技术对局部晚期非小细胞肺癌临床效果比较
Comparison of Clinical Effect of Step-and-shoot Intensity Modulated Radiotherapy and Volumetric Modulated Arc Therapy for Locally Advanced Non-Small Cell Cancer
投稿时间:2016-01-10  
DOI:10.11735/j.issn.1004-0242.2016.09.A015
中文关键词:  非小细胞肺癌  容积旋转调强  适形调强放疗
英文关键词:non-small cell cancer  volumetric modulated arc therapy  intensity-modulated radiation therapy
基金项目:江苏省第十二批六大人才高峰项目(WSW-024)
作者单位
李丹明 南京医科大学第一附属医院 
王 黎 南京建邺医院 
王沛沛 南京医科大学第一附属医院 
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中文摘要:
      摘 要:[目的] 比较局部晚期非小细胞肺癌(NSCLC)常规静态调强(step-and-shoot intensity-modulated radiation therapy,sIMRT)和容积旋转调强(volumetric modulated arc therapy,VMAT)的临床效果。[方法] 回顾性分析68例分别行IMRT和VMAT的NSCLC患者资料,IMRT组38例,VMAT组30例。比较两组患者的近期、远期疗效及急性不良反应。[结果] IMRT组和VMAT组的有效率分别为76.3%和80.0%。除放射性食管损伤外(P=0.045),其他急性不良反应两组均无显著性差异(P>0.05)。IMRT组和VMAT组中位OS分别为23.0个月(95%CI:20.4~25.5)和24.3个月(95%CI:21.6~26.9);PFS分别为15.5个月(95%CI:13.5~17.6)和16.2个月(95% CI:13.5~18.9);局部复发时间分别为17.1个月(95%CI:14.6~19.6)和18.4个月(95%CI:15.8~21.1);远处转移时间分别为20.3个月(95%CI:17.5~23.1)和20.8个月(95% CI:17.5~24.1),差异均无统计学意义(P>0.05)。[结论] VMAT能够获得与IMRT相同的临床疗效,且可降低放射性食管损伤的发生率。
英文摘要:
      Abstract:[Purpose] To compare the clinical effect of step-and-shoot intensity modulated radiotherapy(sIMRT) and volumetric modulated arc therapy(VMAT) for locally advanced non-small cell lung cancer(NSCLC). [Methods] The data of 68 cases with advanced NSCLC received IMRT(n=38) or VMAT(n=30) were included and analyzed retrospectively. The short-term and long-term clinical efficacy and acute toxicity between the two groups were evaluated. [Results] The total efficacy for IMRT and VMAT group was 76.3% and 80.0% respectively. Except fo radiation esophagitis(P=0.045),there was no significant difference for acute toxicity between the two groups(P>0.05). The median time to OS for IMRT and VMAT group were 23.0 months(95%CI:20.4~25.5) and 24.3 months(95%CI:21.6~26.9) respectively,the median time to PFS was 15.5 months(95%CI:13.5~17.6) and 16.2 months(95%CI:13.5~18.9),the median time of local-regional recurrence(LRR) was 17.1 months(95%CI:14.6~19.6) and 18.4 months(95%CI:15.8~21.1),the median time of distant metastasis(DM) was 20.3 months(95%CI:17.5~23.1) and 20.8 months(95%CI:17.5~24.1) respectively, there were no statistical differences between two groups for above 4 indexes(all P>0.05). [Conclusion] VMAT achieves the same clinical efficacy as IMRT and can reduce the incidence of radiation esophagitis in locally advanced NSCLC.
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