立体定向放疗与全脑放疗对肺癌脑转移瘤近期疗效的影响
Effects of stereotactic radiotherapy and whole brain radiotherapy on short-term efficacy in lung cancer with brain metastases
刘永志 1王红旗1
作者信息
- 1. 平煤神马医疗集团总医院放疗科,河南平顶山 467000
- 折叠
摘要
目的 分析立体定向放疗(stereotactic radiotherapy,SRT)与全脑放疗(whole brain radiotherapy,WBRT)对肺癌脑转移瘤近期疗效及疼痛、血清基质金属蛋白酶-9(MMP-9)、胰岛素样生长因子-1(IGF-1)及神经认知功能的影响.方法 选取2020年12月—2022年12月平煤神马医疗集团总医院收治的肺癌脑转移瘤患者81例,按照治疗方式不同分为SRT组(n=40)和WBRT组(n=41).SRT组采用SRT治疗,WBRT组采用WBRT治疗.比较两组近期疗效、放疗前和放疗后NRS评分、血清MMP-9、IGF-1水平,并比较放疗前、放疗后及放疗后3个月两组神经认知功能、生活质量.结果 SRT组客观缓解率高于WBRT组(P＜0.05),两组疾病控制率比较,差异无统计学意义(P＞0.05);放疗后,两组NRS评分和血清MMP-9、IGF-1水平较放疗前降低(P＜0.05),且SRT组低于WBRT组(P＜0.05);放疗后及放疗后3个月,SRT组MMSE评分、MoCA评分和QLQ-C30评分较放疗前明显升高(P＜0.05),且放疗后3个月高于放疗后(P＜0.05),WBRT组与放疗前比较,差异无统计学意义(P＞0.05).结论 SRT较WBRT更有利于提高肺癌脑转移瘤患者近期疗效,减轻患者疼痛,并降低血清MMP-9、IGF-1水平,有助于提高患者神经认知功能和生活质量.
Abstract
Objective To analyze the effects of stereotactic radiotherapy(SRT)and whole brain radiotherapy(WBRT)on the short-term efficacy,pain,serum matrix metalloproteinase-9(MMP-9),insulin-like growth factor-1(IGF-1)and neurocognitive function in lung cancer with brain metastases.Methods Totally 81 patients with lung cancer compli-cated with brain metastases admitted to General Hospital of Pingmei Shenma Medical Group from December 2020 to De-cember 2022 were selected and divided into SRT group(n=40)and WBRT group(n=41)according to different treat-ment methods.SRT group.was treated with SRT,and WBRT group was given WBRT.The short-term efficacy,NRS score and serum MMP-9 and IGF-1 levels before and after radiotherapy and neurocognitive function and quality of life before radiotherapy,after radiotherapy and at 3 months after radiotherapy were compared between the two groups.Results The objective remission rate in SRT group was higher than that in WBRT group(P＜0.05),but there was no statistically significant difference in disease control rate between the two groups(P＞0.05).After radiotherapy,the NRS score and levels of serum MMP-9 and IGF-1 in the two groups were reduced compared with those before radiotherapy(P＜0.05),and the score and levels in SRT group were lower than those in WBRT group(P＜0.05).After radiotherapy and at 3 months after radiotherapy,the MMSE score,MoCA score and QLQ-C30 score in SRT group were significantly enhanced compared with those before radiotherapy(P＜0.05),and the scores at 3 months after radiotherapy were higher than those after radiotherapy(P＜0.05),but there were no statistical differences in WBRT group compared with those be-fore radiotherapy(P＞0.05).Conclusion SRT is more beneficial than WBRT to improve the short-term efficacy,re-lieve the pain,and reduce the levels of serum MMP-9 and IGF-1 in patients with lung cancer and brain metastases,and the former one is more helpful to enhance the neurocognitive function and quality of life of patients.
关键词
立体定向放疗/全脑放疗/肺癌/脑转移瘤/疼痛Key words
Stereotactic radiotherapy/Whole brain radiotherapy/Lung cancer/Brain metastases/Pain引用本文复制引用
出版年
2024
NETL
NSTL
万方数据