A comparative study on the therapeutic effect of chemotherapy combined with large seg-ment radiotherapy or hypersegment radiotherapy in the treatment of limited stage small cell lung cancer
Objective The purpose of this study is to compare the efficacy of chemotherapy combined with high-di-mensional radiotherapy or high-dimensional radiotherapy in the treatment of limited stage small cell lung cancer.Method Eighty patients with limited stage small cell lung cancer admitted to Zhejiang Xin'an International Hospital from January 2018 to February 2023 were randomly divided into a hypersegmentation group and a large segmentation group,with 40 cases in each group.The two chemotherapy regimens were the same,both using the cisplatin+etoposide regimen,intravenous infu-sion of etoposide(5mL:0.1g)at a dose of 100mg/m2,d1-3;intravenous injection of cisplatin at a dose of 75mg/m2,d1.The chemotherapy cycle was 21 days,with a total of 6 cycles.Starting from the second cycle of chemotherapy,combined with ra-diotherapy.The hyperfractionation group received hyperfractionation radiotherapy with a total dose of 45 Gy,each dose of 1.5 Gy,twice a day,with a minimum interval of 6 hours between the two radiotherapy sessions,and 5 days of radiotherapy per week;The large segmentation group was given large segmentation radiotherapy,with a total dose of 55 Gy,each dose of 2.5 Gy,once a day,and 5 days of radiotherapy per week.Observe two groups of clinical efficacy(recent efficacy and progression free survival(PFS),tumor indicators(carcinoembryonic antigen(CEA),vascular endothelial growth factor receptor(VEGFR),endostatin(ES),circulating endothelial cells(CEC),T lymphocyte subsets(CD3+,CD4+,CD8+),quality of life(using KPS score),and≥grade 3 adverse events.Results(1)Recent therapeutic effects.There was no statistically significant difference in ORR rates between the large segmentation group and the hypersegmentation group(92.50％&85.00％)(x2=1.127,P=0.288);the disease progression free survival in the large segmentation group[(20.80±2.12)months]was higher than that in the hy-persegmentation group[(15.00±1.87)months],and the difference between the two groups was statistically significant(x2=4.068,P=0.044).(2)Tumor indicators.After treatment,CEA、VEGFR1、VEGFR2 and CEC in both groups decreased com-pared to before treatment,while ES increased compared to before treatment(all P＜0.05);There was no statistically signifi-cant difference in various indicators between the two groups(P＞0.05).(3)T lymphocyte subpopulations.After treatment,CD3+、CD4+and CD4+/CD8+all increased compared to before treatment.The large segmentation group had higher levels than the ultra segmentation group,while CD8+decreased compared to before treatment.The large segmentation group had lower levels than the ultra segmentation group(all P＜0.05).(4)Quality of life.The quality of life in the large segmentation group was better than that in the super segmentation group(Z=2.006,P=0.045).(5)Adverse events.There was no statistically sig-nificant difference in the incidence of radiation-induced esophagitis,radiation-induced pneumonia,radiation-induced tra-cheitis,bone marrow suppression,and liver function damage between the two groups(P＞0.05).Conclusion The efficacy and safety of using large fractionated radiotherapy combined with chemotherapy for limited stage small cell lung cancer are simi-lar to those of using hyperfractionated radiotherapy combined with chemotherapy.However,large fractionated radiotherapy combined with chemotherapy can improve immune function,improve quality of life,and increase disease-free survival.
limited stage small cell lung cancerchemotherapylarge segmentation radiotherapyhyperfractionated radiotherapyimmune functionquality of life
万方数据
维普
