Clinical Study Of Spiral Tomography Combined With Hyperthermia In The Treatment Of Locally Advanced Non-small Cell Lung Cancer

Objective:This investigation aims to assess the short-term efficacy,adverse effects,and quality of life enhancem ent of helical tomotherapy(TOMO)in conjunction with hyperthermia for locally advanced non-small cell l ung cancer(LA-NSCLC)patients.Additionally,it explores the mechanism and contributing factors of radia tion-induced lung injury(RILI)in LA-NSCLC cases.Material and Method:From July 2021 to August 2022,64 eligible LA-NSCLC patients admitted to our hospital’s oncology department were enrolled in this study.Participants were divided into two groups:the experimental group(n=32)received TOMO combined with hyperthermia,while the control group(n=32)underwent TOMO alone.After a six-month follow-up,general data(gender,age,tumor location,tumor diameter,histological type,clinical stage,smoking history,COPD,KPS score,radiotherapy dose,concomitant chemotherapy,etc.),short-term therapeutic outcomes,quality of life improvements,incidence,and categorization of toxicities and side effects were statistically analyzed for both groups.Comparisons were made to determine any significant differences between the cohorts.Univariate and multivariate analyses were employed to evaluate spiral tomography radiotherapy for locally advanced NSCLC.Statistical Methods:Quantitative data are represented as(x±s),while categorical data are denoted as(%)and analyzed using t-tests,χ~2tests,or Fisher’s exact probability method.Rank sum tests were conducted for ordinal data,and Logistic regression analysis was utilized to examine the influencing factors of RILI in locally advanced NSCLC post-TOMO.A statistically significant difference was indicated by P<0.05.Results:No significant differences were observed in baseline data between both groups(P>0.05).The experimental group displayed a markedly higher efficacy rate of 81.25%,compared to the control group’s 56.25%,with the difference being statistically significant(P<0.05).In the experimental group,24 patients experienced enhanced quality of life,7 patients maintained stable quality,and 1 patient faced a decline in quality.Conversely,the control group comprised 13 patients with improved quality of life,15 patients with stable quality,and 4 patients with decreased quality.The experimental group’s quality of life was significantly superior to that of the control group(P<0.05).The occurrence of radiation-induced lung injury in the experimental group(40.63%)was substantially lower than the control group’s incidence(87.50%),with a statistically significant difference(P<0.05).Early radiation-induced lung injury incidence in the experimental group was 25.00%,significantly lower than the control group’s 50.00%(P<0.05).Among the experimental group,8 patients developed early radiation-induced lung injury,including 5 patients with grade 1,2 patients with grade 2,1 patient with grade 3,and 0 patients with grade 4.In the control group,16 patients experienced early radiation-induced lung injury:5 with grade 1,6 with grade 2,4 with grade 3,and 1 with grade 4.A significant statistical difference was observed between the experimental and control groups(P<0.05).The experimental group exhibited a 15.63%lower incidence of late radiation-induced lung injury compared to the control group(37.50%),with the difference being statistically significant(P<0.05).In the experimental group,5 patients developed advanced radiation-induced lung injury:4 with grade 1,1 with grade 2,and none with grades 3 or 4.The control group had 12 patients with advanced radiation-induced lung injury:3 with grade 1,7 with grade 2,2 with grade 3,and none with grade 4.A significant statistical difference was found between the experimental and control groups(P<0.05).Nevertheless,no statistical difference in side effect incidence,such as bone marrow suppression,radiation dermatitis,radiation esophagitis,digestive tract reactions,and liver function damage,was observed between the two groups(P>0.05).Univariate analysis revealed that radiation dose(P<0.05),combined chemotherapy(P<0.05),coexisting COPD(P<0.05),and combined hyperthermia(P<0.05)influenced radiation-induced lung injury in patients with locally advanced non-small cell lung cancer following TOMO.Multivariate analysis determined that radiation dose(P<0.05),combined chemotherapy(P<0.05),coexisting COPD(P<0.05),and combined hyperthermia(P<0.05)were independent factors impacting radiation-induced lung injury in patients with locally advanced non-small cell lung cancer after TOMO treatment.Conclusion:In comparison to TOMO as a standalone treatment,helical tomotherapy integrated with hyperthermia augments the short-term efficacy for patients diagnosed with locally advanced non-small cell lung cancer,thus enhancing treatment efficiency.Concurrently,this approach facilitates local symptom alleviation and elevates patients’quality of life.Furthermore,it significantly reduces the prevalence of radiation-induced lung injury,especially diminishing the incidence of grade 2 and above injuries.It has been corroborated that radiotherapy dosage,chemotherapy,COPD,and hyperthermia serve as influential factors contributing to radiation-induced lung injury in patients with locally advanced non-small cell lung cancer following helical tomotherapy.