放疗联合NP方案同步或序贯化疗治疗Ⅲ期非小细胞肺癌的临床研究  

Study of concurrent versus sequential chemoradiotherapy with vinoreibine and cisplatin in stage Ⅲ non -small cell lung cancer

作　　者：侯良宝[1] 李红霞 刘彦中[1] 

机构地区：[1]河南第一荣康医院放疗科,河南新乡453003 [2]新乡市卫滨区医保中心

出　　处：《中国民康医学》2009年第1期8-10,共3页Medical Journal of Chinese People’s Health

摘　　要：目的：为了比较放射治疗联合长春瑞滨（NVB）加顺铂（DDP）同步或序贯化疗治疗Ⅲ期非小细胞肺癌（non—small cell lungcancer，NSCLC）的疗效及毒副反应。方法：将60例Ⅲ期NSCLC患者随机分成2组，同步放化疗组（30例）：放疗第1天即同时开始化疗；序贯放化疗组（30例）：入组后先予化疗2个疗程，再单独予放疗．放疗结束后再化疗2～3个周期。结果：近期有效率（CR＋PR）同步放化疗组为76．7％，序贯放化疗组为53．3％（x^2=3．590，P=0．058）。1、2、3年生存率同步放化疗组70％、43．3％、20％，序贯放化疗组53．3％、20％、10％。2组生存率差异无统计学意义（x^2=3．774，P=0．052）。同步放化疗组血液学毒性与放射性食管炎较序贯放化疗组严重，P〉0．05；但经治疗后，患者大多能耐受。结论：放射治疗联合NVB加DDP同步放化疗治疗Ⅲ期NSCLC的疗效优于序贯放化疗，不良反应增大但可耐受，值得进一步研究。Objective ： The objective of this study was to compare the effect and the clinical toxicity of concurrent and sequential ehemoradiotherapy （CRT） with vinorelbine and cisplatin in stage Ⅲ non -small cell lung cancer （ NSCLC） patients. Methods：60 patients with stage Ⅲ NSCLC were randomly assigned into two groups. Concurrent CRT group （30 cases） ： When radiotherapy （RT） was the started, chemotherapy （CT） was started on the first day. Sequential CRT group （30 cases） ： Accepted 2 cycles CT before RT, when RT was finished, then accepted 2 - 3 cycles CT. Results ： The overall response rate （ CR ＋ PR ） was significantly higher in the concurrent CRT group （ 76.7% ） compared with the sequential CRT group （ 53.3% ） , （ x^2 = 3. 590,P = 0. 058 ）. The 1 - year, 2 - year and 3 - year survival rates were 70.0% , 43.3% , 20.0% in the concurrent CRT group , and 53.3% , 20.0% , 10.0% in the sequential CTR group . No difference was found in two group survival rate（ x： = 3. 774,P = 0.052 ）. Blood cell decline and esophageal toxicity were significantly more frequent in the concurrent CRT group than those in the sequential CRT group , P 〉 0.05. However, the toxicities were tolerable by treated. Conclusions： In this study population, concurrent CRT with vinorelbine and eisplatin in stage Ⅲ NSCLC demonstrated significant benefit in terms of response rate. The concurrent CRT was associated with higher toxicity; however, the toxicity was tolerable. In is valuable to investigate more deeply.

关 键 词：癌 非小细胞肺/放射疗法 癌 非小细胞肺/化学疗法 长春瑞滨 

分 类 号：R734.2[医药卫生—肿瘤]