同步放化疗治疗非小细胞肺癌临床结果  

Concurrent chemotherapy and radiotherapy for advanced non-small-cell lung cancer

作　　者：卢冰[1] 欧阳伟炜[1] 付和宜[1] 肖翊[1] 姜彬[1] 王仁敏[1] 

机构地区：[1]贵阳医学院附属医院肿瘤科,贵阳550004

出　　处：《中华放射肿瘤学杂志》2004年第3期177-179,共3页Chinese Journal of Radiation Oncology

摘　　要：目的探讨同步放化疗联合治疗Ⅲ期非小细胞肺癌的近期疗效、生存期、生活质量及毒性反应。方法将44例Ⅲ期非小细胞肺癌按治疗方法归入两组,同步放化疗联合治疗组(同步组)27例(ⅢA期14例,ⅢB期13例);序贯放化疗组(序贯组)17例(ⅢA期8例,ⅢB期9例)。全组病例化疗采用以铂类药物为主组成的化疗方案,中位周期数为2.0。放疗采用6、15MVX线,DT<60Gy6例,60～70Gy19例,>70Gy2例;分割剂量为2Gy/(次·d),5次/周。分别比较两组的近期疗效、生存率、卡氏评分(KPS)变化及骨髓毒性。结果同步组与序贯组病例的完全缓解率、有效率、KPS改善率分别为26%和23%,74%和65%、75.6%和68.3%,经统计学检验差异均无显著性意义。两组病例的生存曲线和治疗毒性相似。结论同步放化疗联合治疗局部晚期非小细胞肺癌有优于序贯放化疗综合治疗的趋势;同步放化疗联合治疗未增加治疗毒性。Objective To evaluate the response, survival, quality of life and toxicity of concurrent chemoradiotherapy for stage Ⅲ non small cell lung cancer (NSCLC). Methods Fouty four patients with stage Ⅲ NSCLC were treated from Nov. 1997 to Dec. 2002. Seventeen patients (8 stage ⅢA and 9 stage ⅢB) treated by sequential chemoradiotherapy(S group) from Nov. 1997 to July. 1999 and 27 patients(14 stage ⅢA and 13 stage ⅢB )treated by concurrent chemoradiotherapy (C group) from July. 1999 to Dec. 2002 received cisplatin based chemotherapy ranging from 1 to 6 cycles(median 2 cycles).Radiotherapy was dilivered by 6 MV/15 MV X. Six patients received D T<60 Gy;19 patients received <66 70 Gy and 2 patients > Gy. The total dose was 50 73 Gy.Fractionations of 2 Gy/fraction/day was delivered,10 Gy/5 fractions/week.Results Comparison of complete response rate (CRR),overall response rate (ORR) and 1 ,2 ,3 year survival rates,Karnofsky performance status (KPS) and improvement in C and S groups showed 26% and 23%;74% and 65%;74.1% and 58.8%;50.7% and 23.5%; 40.5% and 23.5%;75.6% and 68.3%. Toxicity rate was similar in C and S groups. There is a trend of concurrent grouop being superior to sequential group (P>0.05), especially the survival rate of stage ⅢA disease.Conclusions Concurrent chemoradiotherapy seems to be better than the sequential counter part for NSCLC,without 3 increasing the toxicity.

关 键 词：同步放化疗 联合治疗 序贯 Ⅲ期非小细胞肺癌 临床结果 近期疗效 病例 结论 趋势 显著性 

分 类 号：R734.2[医药卫生—肿瘤]