化疗和放射治疗非小细胞肺癌的顺序与时机  

Time and sequence of chemotherapy and radiotherapy in treatment of non-small cell lung cancer

作　　者：蒋月[1] 葛红[1] 单娟[1] 沙永慧[1] 

机构地区：[1]河南省肿瘤医院放疗科,河南郑州450008

出　　处：《肿瘤防治杂志》2005年第19期1499-1501,共3页China Journal of Cancer Prevention and Treatment

摘　　要：目的:通过局部晚期非小细胞肺癌(nonsmall cell lung cancer,NSCLC)先化疗后放疗(序贯疗法)和放化同步治疗(相伴疗法)两组的疗效比较,探讨NSCLC化疗和放疗的顺序与时机.方法:40例Ⅲ期NSCLC患者分两组.先化疗后放疗组(序贯组,20例)和放疗与化疗同步治疗组(同步组,20例).序贯组为先诱导化疗3个周期后开始放射治疗,放疗结束后再化疗1个周期.同步组治疗方式为于第1周期化疗的同时开始放射治疗.两组患者放射治疗技术和剂量相同,总剂量60 Gy/6周,照射野包括原发灶、肺门和纵隔,少数患者加照双侧锁骨上区.化疗方案:NP方案,即去甲长春花碱(NVB)+顺铂(DDP),NVB 25 mg/m2,d1、d8;DDP 20 mg/m2,d1～d4,共4个周期.结果:治疗后序贯组、同步组的缓解率分别为75%和80%,两组近期疗效差异无统计学意义,χ2=0.00,P=1.000.1、2和3年生存率序贯组分别为65%、25%和15%;同时组分别为70%、40%和30%,差异无统计学意义,χ2=0.98,P=0.322.中位生存期分别为16和18个月,f=0.986,P=0.331.3～4级骨髓抑制发生率同时组高于序贯组,但均可耐受.结论:放化同时相伴治疗NSCLC是一种较好的治疗方式.OBJECTIVE： To compare the survival rates of sequential versus concurrent modalities of radiotherapy plus chemotherapy for Stage Ⅲ non-small cell lung cancer （NSCLC）. METHODS： From January 1999 to December 2000, 40 patients with Stage Ⅲ NSCLC were randomized into two groups： 20 patients in the sequential group （S）, 20 patients in the concurrent group （C）. Radiotherapy was started after three cycles of induction chemotherapy in Group S and radiation started on the first cycle of chemotherapy in Group C. All patients received conventional radiotherapy. The total tumor dose was 60 Gy/6 weeks. Chemotherapy schedule consisted of four cycles of vinorelbine 25 mg/m^2 on day 1. 8 and cissplatin 20 mg/m^2 on day 1- 4 of a 21-day cycle. RESULTS： The overall response rates （CR＋ PR） of Group S and Group C were 75% and 80 %, respectively, X^2=0.00, P= 1. 000. The median survival time was 16 months in Group S and 18 months in Group C. The 1- ,2- and 3-year survival rates were 65% ,25% ,15% and 70% ,40%, 30%. respectively in Group S and Group C, X^2= 0. 98, P=0. 322. Severe hematologic toxicity were significantly frequent in Group C which could be tolerated. CONCLUSION： Concurrent chemotherapy plus radiotherapy is a good way in the treatment of NSCLC.

关 键 词：癌 非小细胞肺/放射疗法 癌 非小细胞肺/药物疗法 综合疗法 

分 类 号：R734.2[医药卫生—肿瘤]