Treatment Of Image Guided Large Fractionated Radiotherapy And Concurrent Chemotherapy Clinical Observation Of Non Small-Cell Lung Cancer

Objective: To evaluate the efficacy,safety and clinical significance of image guided hypofractionated radiotherapy concurrent with chemotherapy for Non Small-Cell Lung Cancer(NSCLC)through the retrospectively observation of the clinical effects and survival time.Method: A total of 210 cases from Handan Central Hospital which were in stage IIIB and stage IV NSCLC from July 5,2013 to July 10,2015 are taken into consideration.They were divided into two groups randomly according to statistical method,which are experimental group(image guided large fractionated radiotherapy and concurrent chemotherapy drug treatment group)and control group(concurrent chemotherapy drug treatment group).The experimental group was under a conventional dose of pemetrexed drug and cisplatin chemotherapy as well as a radiotherapy of 47Gy/13 times,5-6 times per week,4Gy per time,2 weeks completed.While the control group only had two kinds of chemotherapy(pemetrexed drug and cisplatin).Hepatoprotective,nutritional supportive,antiemetic and other measures were given to both two groups for prevention of drug toxicity during the treatments.Evaluating the safety,efficacy and clinical significance of the treatment plan was through the analysis of clinical data and pathological characteristics.Survival rate and toxic or side effects were also observed at the same time.Data were analyzed by SPSS21.0 medical statistical methods,Fisher's exact test and inspection were used in composition ratio and comparison between the two groups in the rate.With Kaplan Meier method partial control rate and total survival rate are computed.Log-rank test was used for patient survival analysis.Result: 1 curative effect comparison between the two groups of patientsthe experimental group patients,the total effective rate was 58.1% higher than in the control group 44.8% percent more obvious,difference between group than was statistically significant(P < 0.05).Show that image guided by large divided radiotherapy synchronous chemotherapy is pure chemotherapy curative effect is better,to lose opportunity or cannot tolerate surgery of patients with stage III lung cancer,tolerated experimental scheme can be used as priorities.2 toxicity comparison between two groups of patientstwo groups of patients were successfully completed treatment,toxicity of the WHO classification standard grade 1 ~ 2 more common,3 ~ 4 rare adverse reactions.Among them,the treatment group and 49 patients in the gastrointestinal tract reaction,neutropenia observed in 44 patients,6 patients become infected,16 cases with anemia,23 cases appear hair loss,14 cases of a skin rash;Control group of 42 patients in the gastrointestinal tract reaction,neutropenia observed in 41 patients,3 cases of infected patients,16 cases of anemia,21 cases of hair loss,23 cases a skin rash.Various related laboratory indexes in experimental group,neutrophils reduced circumstances,infections,anemia,gastrointestinal tract reaction,hair loss and skin rash slightly heavier than the control group's incidence degree,but there was no statistically significant difference(P > 0.05).Show chemoradiation is only did not significantly increase the toxicity of chemotherapy.3 experimental treatment effect and the patients clinical biological characteristicsthe relationship between the biological factors,clinical curative effect and patients treated group differences between different gender,age,pathological type,tumor intrusive has nothing to do,no difference of statistics meaning(P > 0.05),and smoking status,number of extrapulmonary organ metastasis have positive correlation item,the difference was statistically significant(P < 0.05)4 The comparison of the prognosis of patients with two groups of timeGroup of patients survival time was extended,the difference was statistically significant(P = 0.007).6 months,1 year,2 years survival rate respectively(experimental group 84.9% vs 75.6% in control group,experimental group 81.3% vs 68.5% in control group,experimental group 52.0% vs 20.8% in the control group)Conclusions:1 relative to pure drugs during chemotherapy,patients better for the treatment of non-small cell lung cancer,and effectively improve the general condition and side effects compared with chemotherapy alone group have no obvious increase.The prognosis of patients with2 to prolong the survival time compared with controls.Under the patient's body and the economic conditions allow,the experimental scheme for treatment with positive clinical significance,has actively promote value in the field of LANSCLC of diagnosis and treatment.3 radiotherapy chemotherapy treatment LANSCLC adverse reactions during this period,the whole body bone marrow mild inhibition and slightly radioactive damage,using the segmentation technology improve the equivalent biological dose radiotherapy and side effects not seen obvious increase,increase the patient's tolerance and curative effect,safe.4 In view of this study sample size is less,follow-up time is short,the final conclusion there may be a deviation.But from the test conclusion shows LANSCLC patients benefit,continue to observe the forward information need to increase the sample size.