Postoperative Radiotherapy Dose Analysis Of Thymoma And Meta Analysis Of Baihe Gujin Decoction In Preventing And Treating Radiation Pneumonia

Purpose: 1.To analyze the dosage of adjuvant radiotherapy after thymoma surgery,and to find the most suitable treatment technology for patients.2.To provide evidence-based medical evidence for clinical application of Baihe Gujin Decoction in the prevention and treatment of radiation pneumonia by meta-analysis.Material and method: 1.Collect patients with thymoma of type B2 and above type B2 who received radiotherapy in the radiation therapy department of the Northern District General Hospitalfrom 2016 to 2018.According to the actual situation,they were divided into three-dimensional conformal group and intensity-modulated radiotherapy group.The metrological differences between the target area and the endangered organs were compared.2.Analyze the effect of traditional Chinese medicine for preventing and treating radiation pneumonitis with.Chinese herbal formula Baihe Gujin Decoction by META analysis,then search WANFANG Medical Data,China Knowledge National Infrastructure(CNKI),United States National Library(Pub Med),and WEIPU Chinese Science and Technology Journal Database,and finally select relevant Chinese and English literature which were published before October 2018.Exclude articles and journals that are not relevant to the topic by reading the title and abstract of the article.The selected articles are included or excluded in strict accordance with the established article inclusion and exclusion criteria.Statistical analysis was performed using the REVMAN 5.3 system evaluation software provided by the Cochran Collaboration.To assess the incidence of radiation pneumonitis,the incidence of radiation esophagitis,and the incidence of total radiation pneumonitis.Results: 1.The dose distribution of PTV V95%,V110%,HI and CI had statistical significance.There was no significant difference between V100% and Dmean(P=0.006,P=0.046,P=0.013,P=0.022,P=0.278,P=0.429);V5 IMRT group was higher than 3D-CRT group,V20,V30 and Dmean in IMRT group were lower than those in 3D-CRT group,V5,V20 had statistical significance,V30,Dmean had no statistical difference(P=0.001,P=0.429).048,P = 0.980,P = 0.128;there was no significant difference in V30,V40 and Dmean between the two groups in cardiac dose distribution(P = 0.499,P = 0.243,P = 0.216).There was no significant difference in spinal cord Dmax,Dmean,esophageal V50 and Dmean.2.There are total 7 articles reporting the incidence of radiation pneumonitis,heterogeneity test results X2 = 0.31,P = 1.00 > 0.1,I2 = 0% < 50%,combined effect: RR = 0.29,95% CI = [ 0.09,0.76],Z=5.50(P<0.000001),the difference was statistically significant;there were 4 references comparing the incidence of radiation esophagitis before and after radiotherapy,heterogeneity test X2=6.18,P=0.10,I2=51% >50%,combined effect size: RR=0.19,95% CI=[0.12,0.31],Z=6.97(P<0.00001),the difference was statistically significant;a total of 11 reports reported that there are always treatments for radiotherapy pneumonia Efficiency,heterogeneity test X2=12.06,P=0.28>0.1,I2=17%<50%,combined effect amount: RR=5.57,95%CI=[3.62,8.57],Z=7.28(P<0.00001).Conclusions: 1.This research shows that IMRT is superior to 3D-CRT in terms of conformity and uniformity in the target area and protection of lung tissue in patients after thymoma surgery,being advantageous in dosimetry.2.Chinese herbal formula Baihe Gujin Decoction can effectively prevent radiation pneumonitis,combined with conventional western medicine treatment can improve the cure rate of patients and improve the life quality of patients.