多西他赛联合顺铂同步放疗治疗局部晚期非小细胞肺癌随机对照临床研究  

Docetaxel plus Cisplatin Chemotherapy with Concurrent Three Dimensional Conformal Radiotherapy for Locally Advanced Non-Small-Cell Lung Cancer

作　　者：王颂平[1] 宋海平[1] 徐建华[1] 阎文娴 

机构地区：[1]青岛市肿瘤医院,山东省青岛市266042

出　　处：《中国肿瘤临床》2009年第13期736-739,共4页Chinese Journal of Clinical Oncology

摘　　要：目的:比较多西他赛联合顺铂同步放疗及序贯放疗治疗局部晚期非小细胞肺癌的生存期、疗效和不良反应。方法:98例不可手术的局部晚期非小细胞肺癌患者随机分为2组。所有患者均给予三维适形放疗。序贯放化疗组:多西他赛75mg/m^2,顺铂75mg/m^2,分为3天,d1-3。化疗每三周重复,共2周期。化疗后三周行胸部放疗。同步放化疗组:多西他赛30mg/m^2,顺铂20mg/m^2,第1,8,22,29天,放疗从第1天开始。两组放疗剂量均为56-66GT,每次2GY,1周5次,共5～7周。结论:序贯放化疗组有效率56%,同步放化疗组有效率75%,P<0.05。同步组中位生存期16.75月,1,2,3年生存率分别为60.4%,33.3%,20.8%。序贯组中位生存期13.75月,1,2,3年生存率分别为52%,24%,14%。同步放化疗组放射性食道炎的发生率高于序贯组,41.6% vs 20%,P<0.05。结论:多西他赛联合顺铂同步放疗较序贯放疗治疗局部晚期非小细胞肺癌疗效高,生存期长。Objective： To compare the survival impact, efficiency and toxicity between concurrent and sequential treatment of radiotherapy （RT） and chemotherapy （CT） for unresectable stage Ⅱ[ non-small-cell lung cancer （NSCLC）. Methods： Patients were randomly assigned to two treatment arms. All patients received three-dimensional conformal radiotherapy （3D-RT）. In the sequential arm, patients received induction CT with docetaxel （75mg/m2） on day 1 and 22, and cisplatin （75mg/m2） from day 1 to 3 and day 22 to 24 followed by thoracic RT. In the concurrent arm, the same RT was started on day 1, with docetaxel （30mg/m2） and cisplatin （20mg/m2） on day 1, 8, 22, and 29.3D-RT was administered at a total dose of 56-66 Gy （daily fraction of 2 Gy, 5 days/wk） for 5 to 7 weeks. Results： A total of 98 patients were randomly assigned. The response rates of sequential and concurrent groups were 56% and 75%, respectively. The median survival was 13.75 months in the sequential arm and 16.75 months in the concurrent arm. The 1-, 2-, and 3-year survival rates were 60.4%, 33.3%, and 20.8% in the concurrent arm and 52%, 24%, and 14% in the sequential arm, with a significant difference （P〈0.05）. Esophageal toxicity was significantly more frequent in the concurrent arm than in the sequential arm （41.6% vs 20%）. Conclusion： For patients with unresectable non-small-cell lung cancer, concurrent treatment of chemoradiotherapy is more effective than sequential chemoradiotherapy.

关 键 词：癌 非小细胞肺/三维适形放射疗法化疗 同步放化疗 序贯放化疗 

分 类 号：R734.2[医药卫生—肿瘤] R978.1[医药卫生—临床医学]