同步放化疗治疗Ⅲ期非小细胞肺癌临床研究  

Clinical trial of concomitant radiochemotherapy for stage Ⅲ non small cell lung cancer

作　　者：尹刘[1] 姚春梅[1] 况成国[1] 

机构地区：[1]安徽省蚌埠医学院附属淮北矿工总医院,235000

出　　处：《中国临床实用医学》2008年第12期37-39,共3页China Clinical Practical Medicine

摘　　要：目的用PE方案比较同步放化疗与序贯化放疗治疗Ⅲ期不能手术非小细胞肺癌的近期疗效和毒性反应。方法资料完整共计62例患者纳入统计分析。两组患者均用PE方案化疗，顺铂40mg、足叶乙甙200mg第1—3天，每3—4周重复。同步组在放疗第1天开始化疗，序贯组先化疗2个周期后再放疗。放射治疗肿瘤剂量60—63Gy／6—7周。结果同步组与序贯组近期有效率分别是77．4％和63．3％无显著性差别（χ^2=0．93，P=0．818），1、2、3年生存率分别为59．4％、40．1％、28．1％和53．3％、33．3％、20．1％，中位生存时间分别为19．2个月和12．7个月有显著性差别（χ^2=4．588，P=0．032）。常见毒性反应是白细胞减少、恶心、呕吐、放射性食管炎及放射性肺炎，两组发生率相近，差别无显著性。结论同步放化疗对Ⅲ期不能手术的非小细胞肺癌治疗有益，毒性反应发生率有所增加，可耐受。Objective Use PE regimen to evaluate the short-term curative effect and toxicity effects of concurrent ehemo-radiotherapy （CCRT） and sequential chemo-radiotherapy （SCRT） for unreseetable Stage Ⅲ non-small ceil lung cancer. Methods 62 patients with complete record were involved in the statistical analysis. The patients were randomized into 2 groups ,which were both treated by chemotherapy with PE regimen ,with cisplatin 40 mg/m^2 on D1-3 and 200 mg/m^2, etoposide on D1-3, repeated every 3-4 weeks. CCRT group received chemotherapy after the first day of radiotherapy; SCRY group received radiotherapy after two cycles of chemotherapy. Radiotherapy was given to a total dose of 60 Gy-63 Gy/6-7 weeks. Results The overall response rates of CCRT group and SCRY group were 77.4% and 63.3% respectively,and the differences were not significant in terms of immediate response（χ^2 =0. 93 ,P =0. 818）. The 1-,2-and 3-year survival rates were 59.4% ,40. 1% , 28.1% and 53.3% ,33.3% ,20. 1% in CCRT and SCRT groups; The median survival periods were 19.2 months 19.2 and 12. 7 months respectively, and the difference in the survival rates were quite significant （χ^2 = 4. 588, P = 0. 032）. The common treatment-related toxieities were leukopenia, nausea and vomiting, radiation esophagitis, and pneumonitis; the incidence was similar in both groups,and there were no differences in terms of treatmentrelated toxieities. Conclusion CCRT is one of the beneficial approaches for the treatment of patients with unresectable stage Ⅲ non-small cell lung cancer;the incidence of toxieities increases slightly,however,it is well tolerated.

关 键 词：非小细胞肺癌 放疗 化疗 同步放化疗 

分 类 号：R734.2[医药卫生—肿瘤] R735.1[医药卫生—临床医学]