多西他赛联合奥沙利铂同步化放疗治疗局部晚期非小细胞肺癌临床观察  

CLINICAL OBSERVATION ON DOCETAXEL AND OXALIPLATIN BASED CHEMOTHERAPY AND CONCURRENT RADIOTHERAPY IN LOCAL ADVANCED NON-SMALL-CELL LUNG CANCER

作　　者：李英[1] 刘建敏[1] 沈太春[1] 王秀玲[1] 荆凤英[1] 

机构地区：[1]山东省临清市聊城市第二人民医院放疗科,聊城252600

出　　处：《现代预防医学》2010年第18期3573-3575,3577,共4页Modern Preventive Medicine

摘　　要：[目的]观察多西他赛联合奥沙利铂同步化放疗治疗局部晚期非小细胞肺癌(NSCLC)的临床疗效和毒副反应。[方法]72例Ⅲ期非小细胞肺癌(NSCLC)患者随机分为两组:治疗组35例进行同期放化疗,化疗在放疗开始时同期进行,用药多西他赛75mg/m2d1静脉滴注;奥沙利铂130mg/m2d2静脉滴注。21d为1周期,共2周期。放疗采用X线三维适形放疗,2GY/次,5次/周,总剂量60～70GY/6～7周。对照组37例只行三维适形放疗,具体剂量、分割方式同治疗组。治疗完成后评价疗效和不良反应。[结果]治疗组总有效率(CR+PR)80.0%,完全缓解率(CR)22.9%;对照组总有效率56.8%,完全缓解率10.8%,两组间总有效率差异有统计学意义(χ2=5.77,P﹤0.05)。治疗组1、2年生存率分别为68.6%、42.9%,对照组分别为40.5%、18.9%(1年生存率的卡方检验χ2=5.69,P﹤0.05;2年生存率的卡方检验:χ2=4.86,P﹤0.05)。治疗组肿瘤进展时间平均为10.2个月,单纯放疗组为4.5个月,(Log Rank检验χ2=6.34,P﹤0.05)。两组结果相比差异有统计学意义。治疗中出现的毒副反应主要是放射性肺炎、放射性食管炎、骨髓抑制、消化道反应和外周神经毒性,经对症处理后均顺利完成治疗,无治疗相关死亡。[结论]多西他赛联合奥沙利铂同期放疗可以提高晚期非小细胞肺癌的近期疗效和远期生存率,是一种安全有效的综合治疗手段。[Objective] To observe the effect and toxicity of docetaxel and oxaliplatin based chemotherapy and concurrent radiotherapy in local advanced nonsmall cell lung cancer（NSCLC）.[Methods] Seventy-two local advanced non-small cell lung cancer patients were divided two groups：35 cases in the treatment group received 2 cycles of docetaxel 75mg /m2 at the first day and oxaliplatin 130 mg /m2 at the second day,and 21 days for one cycle.Concurrent 3D-CRT was used;also 2 GY per fraction and 5 fractions were used for 6-7 weeks.The total tumor doses were 60-70 GY.37 cases in the control group received 3D CRT alone.The clinical response was assessed after treatment.[Results] The overall response rate for CR＋PR was 80.0%,and the total remission rate was 22.9%,and the total effective rate was 56.8%,and the complete remittance was 10.8%.There was significant difference between the total effective rate of the two groups（χ2 = 5.77,P﹤0.05）.The one-year and 2-year survival rates of the treatment group were 68.6% and 42.9%,respectively,and the rates of control group were 40.5% and 18.9%,respectively.（The chi-square test for one-year survival rate was 5.69,P﹤0.05;for 2-year survival rate was 4.86,P﹤0.05）.The average progress time was 10.2 months for treatment group,and was 4.5 months for the simple radio-therapy,（Log Rank test：χ2 = 6.34,P﹤0.05）.There was significance difference between the two groups.The drug toxicity reactions were Radiation pneumonitis,bone marrow suppression,digestive tract reaction and peripheral nervous.The treatment presented successfully,and no related death was showed.[Conclusion] Docetaxel and oxaliplatin based chemotherapy and concurrent radiotherapy in local advanced non-small cell lung cancer can improve short term response rate,survival rates and average tumor progress time,and the regiment is well tolerable and effective.

关 键 词：非小细胞肺癌 适形放疗 同期放化疗 多西他赛 奥沙利铂 

分 类 号：R734.2[医药卫生—肿瘤]