恩度同步放疗治疗不能手术的局部晚期非小细胞肺癌发生放射性肺炎的临床观察

Clinical Observation of Radiation Pneumonitis in the Treatment of Inoperable Locally Advanced Non-Small Cell Lung Cancer with Endostar Simultaneous Radiotherapy

摘要: 目的：观察恩度(重组人血管内皮抑制素)联合放疗治疗不能手术的局部晚期非小细胞肺癌过程中能否减少放射性肺炎的发生。方法：将36例不能手术的局部晚期非小细胞肺癌患者随机分为恩度联合放疗组(联合组)和单纯放疗组(放疗组)，其中联合组17例。联合组采用恩度7.5 mg/d，连续给药7天，在放疗前7天开始给药，隔周重复，共6周期；同时行调强放疗，放疗采用常规分割，原发灶及纵隔淋巴结放疗剂量为56~64 Gy/28~32次，放疗组19例仅接受调强放疗，剂量、分割方式同联合组。观察两组患者放疗过程中和放疗结束6个月内出现放射性肺炎的例数及严重程度。结果：联合组共有4例放射性肺炎发生，其中4例均为1级。放疗组共有8例放射性肺炎发生，其中1级5例，2级2例，3级1例。结论：恩度同步放疗治疗不能手术的局部晚期非小细胞肺癌对比单纯放疗组放射性肺炎的产生未见明显差异。

Abstract: Objective: To observe whether Endostar (recombinant human vascular endostatin) combined with radiotherapy can reduce the occurrence of radiation pneumonitis in the treatment of inoperable locally advanced non-small cell lung cancer. Methods: A total of 36 patients with inoperable locally advanced non-small cell lung cancer were randomly divided into Endostar combined radiotherapy group (combined group) and radiotherapy alone (radiotherapy group), of which 17 cases were combined group. In the combination group, Endo 7.5 mg/d was administered for 7 consecutive days, starting 7 days before radiotherapy and repeated every other week for a total of 6 cycles. At the same time, intensity-modulated radiotherapy was performed, radiotherapy was routinely di-vided, the primary lesion and mediastinal lymph nodes radiotherapy dose was 56~64 Gy/28~32 times, and 19 cases in the radiotherapy group only received intensity-modulated radiotherapy, and the dose and division method were the same as those in the combined group. The number and se-verity of radiation pneumonia during radiotherapy and within 6 months after the end of radio-therapy were observed in both groups. Results: A total of 4 cases of radiation pneumonitis occurred in the combined group, of which 4 cases were grade 1. A total of 8 cases of radiation pneumonia oc-curred in the radiotherapy group, including 5 cases in grade 1, 2 cases in grade 2, and 1 case in grade 3. Conclusion: There was no significant difference between the treatment of locally advanced non-small cell lung cancer with inoperable radiotherapy and radiation pneumonitis in the radio-therapy alone group.