Observation of the therapeutic effect of hyperbaric oxygen combined with high-dose prednisolone on 37 cases of acute radiation pneumonia after radiotherapy for malignant thoracic tumor
Objective To investigate the clinical efficacy of hyperbaric oxygen combined with high-dose prednisolone in the treatment of acute radiation pneumonitis(ARP)secondary to radiotherapy for malignant thoracic tumors and its impact on lung function.Methods Clinical data of 74 patients with thoracic malignant tumors complicated with ARP after radiotherapy admitted to Chongming Hospital Affiliated to Shanghai University of Medicine & Health Sciences from April 2019 to April 2023 were selected.According to the random number table method,they were divided into combination group(n=37)and control group(n=37).The control group was treated with high-dose prednisolone(40-60 mg in the morning),while the combination group received hyperbaric oxygen therapy in addition to the treatment of the control group.After four courses of treatment,the therapeutic effect was evaluated based on chest CT examination and clinical symptoms.According to the grading criteria of Radiation Therapy Oncology Group(RTOG)in the United States,RTOG grading was performed on the patients in the two groups before and after treatment.A pulmonary function meter was used to measure the percentage of forced expiratory volume in one second to the predicted value(FEV1％),the percentage of forced vital capacity to the predicted value(FVC％),and the percentage of total lung capacity to the predicted value(TLC％)before and after treatment.The quality of life of the patients in two groups was measured using the Karnofsky Performance Status(KPS)score and the Functional Assessment of Cancer Therapy-Breast(FACT-B)scale before and after treatment.The serum levels of pulmonary fibrosis markers,i.e.,PICP,LN,and PC 111,were detected by radioimmunoassay.Results The total effective rate of the combination therapy group after treatment(94.6％)was significantly higher than that of the control group(78.4％),with a statistically significant difference(x2=4.177,P＜0.05).Compared with the indexes before treatment,the FVC％,TLC％,and FEV1％of both groups increased significantly after treatment(P＜0.05);and the indexes of the combination group were significantly higher than those of the control group after treatment(P＜0.05).After treatment,the RTOG grades of the combination group were significantly better than those of the control group(Z=6.701,P＜0.05).Compared with before treatment,the FACT-B scores and KPS scores in both groups significantly increased after treatment(P＜0.01),and the FACT-B score and KPS score in the combination group were significantly higher than those in the control group after treatment(P＜0.05).Compared with before treatment,the expression levels of serum PICP,LN,and PC Ⅲ in both groups were significantly reduced after treatment(P＜0.01);and the indexes in the combination group were significantly lower than those in the control group after treatment(P＜0.05 or P＜0.01).Conclusion Hyperbaric oxygen combined with high-dose prednisolone has achieved a good clinical efficacy in the treatment of ARP after radiotherapy for malignant thoracic tumors.It can improve patients'lung function,lower RTOG grade,inhibit pulmonary fibrosis,and improve their quality of life.
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