适形放疗同步吉西他滨化疗治疗局部晚期非小细胞肺癌临床研究  

Three dimensional conformal radiotherapy combined with gemcitabine chemotherapy for locally advanced non-small cell lung cancer

作　　者：胡家柱[1] 王希成[2] 谢方云[3] 邹国荣[1] 黎益华[1] 

机构地区：[1]广州市番禺区人民医院肿瘤科,511400 [2]广东药学院附属第一医院放疗科 [3]中山大学肿瘤防治中心放疗科

出　　处：《中国医师进修杂志》2009年第3期20-23,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的评价适形放疗同步吉西他滨化疗治疗局部晚期非小细胞肺癌的近期疗效和急性毒副反应。方法90例晚期非小细胞肺癌患者随机分成两组：治疗组45例采用吉西他滨与三维适形放疗同步治疗，对照组45例采用吉西他滨与常规放疗同步治疗。化疗方案为吉西他滨350mg/m^2。第1、8、15、22、29、36天。放射源为6MV或15MVX线，照射靶区包括转移淋巴结及原发灶和预防性淋巴引流区。结果两组的近期疗效：对照组完全缓解5例（11．1％），有效28例（62．2％）；治疗组完全缓解13例（28．9％），有效38例（84．4％）；治疗组的肿瘤缓解率明显高于对照组，组间比较差异有统计学意义（P〈0．05）。对照组的放射性肺炎、放射性食管炎的发生率分别为28．9％（13／45）、35．6％（16／45），明显高于治疗组的11．1%（5／45）、17．8%（8／45），组间比较差异有统计学意义（P〈0．05）。结论适形放疗同步吉西他滨化疗治疗局部晚期非小细胞肺癌能提高局部晚期非小细胞肺癌患者的近期疗效，急性毒副反应明显低于常规放疗同步吉西他滨化疗，值得进一步临床研究，远期疗效有待进一步随访。Objective To evaluate the acute side effects and efficacy of three dimensional conformal radiotherapy （3D-CRT） combined with gemcitabine chemotherapy for locally advanced non-small cell lung cancer （NSCLC）. Methods From January 2006 to December 2007, 90 cases with advanced NSCLC were. divided into two groups, treatment group of 45 patients were treated with 3D-CRT and gemcitabine, control group of 45 patients were treated with gemcitabine and conventional radiotherapy. Chemotherapy consisted of intravenously gemeitabine 350 mg/m2 on day 1, 8, 15, 22, 29, 36. Radioactive source was used with X ray of 6 MV or 15 MV. Irradiatial target area were lung site and mediastinal node. Results The complete remission （CR）and remission rate（RR） in centrol group were 5 cases （ 11.1% ） and 28 cases （62.2%）, but in treatment group were 13 cases （28.9%） and 38 cases （84.4%）, respectively. The difference of response rate in two groups was significant（P 〈 0.05）. The rate of acute radiation-induced pneumonitis and esophagitis in control group （28.9%, 35.6%）were higher than those in treatment group （ 11.1%, 17.8% ）, there were significant difference between two groups （P 〈 0.05）. Conclusions Concurrent application of gemeitabine and 3D- CRT can improve the RR for locally advanced NSCLC,and the acute toxicity are lower than those of gemcitabine and conventional radiotherapy. The clinical study is needed, but the late effect shoud be followed.

关 键 词：癌 非小细胞肺 放射疗法 计算机辅助 药物疗法 联合 吉西他滨 

分 类 号：R734.2[医药卫生—肿瘤] R730.55[医药卫生—临床医学]