Ⅲ期非小细胞肺癌放化同期治疗临床观察与预后分析  

Analysis of three dimensional conformal radiotherapy combined with chemotherapy in the treatment of stage Ⅲ non-small cell lung cancer and analysis of prognostic factors and its prognostic factors

作　　者：张彬[1] 乔田奎[1] 

机构地区：[1]复旦大学附属金山医院放疗科,上海200540

出　　处：《中国癌症杂志》2010年第9期703-706,共4页China Oncology

摘　　要：背景与目的:放化联合治疗是现今治疗局部晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的标准模式,本研究旨在观察三维适形放疗联合同期化疗治疗局部晚期NSCLC的不良反应与临床疗效。方法:74例符合入组条件的NSCLC患者接受三维适形放疗及同期化疗。观察患者的治疗完成情况,治疗期间、治疗后的放化疗不良反应及临床疗效。结果:全组患者白细胞减少总发生率为91.89%;急性肝肾损伤总发生率为13.51%(10/74)。急性放射性食管炎0级6例,1级22例,2级18例,3级28例,无4级发生。急性放射性肺炎0级4例,1级30例,2级24例,3级16例,无4级发生。治疗结束后完全缓解(CR)6例,部分缓解(PR)64例,稳定(SD)4例,总有效率(PR+CR)为94.60%(70/74)。中位生存期15个月,1、2年生存率72.78%、45.50%。单因素分析显示T分期(P=0.03)、Ⅲa和Ⅲb期(P=0.0006)、疗前体重是否下降(P=0.07)及放射性肺炎严重程度(P=0.02)是影响预后的因素。结论:足量NP与放疗同步应用,不良反应较大,远期疗效未见明显提高。Background and purpose：Three dimensional conformal radiotherapy （3DCRT） combined with chemotherapy is the gold standard for stage Ⅲ of non-small cell lung cancer （NSCLC）.This study evaluated the acute side effects and effi cacy of 3DCRT combined with concurrent chemotherapy for stage Ⅲ NSCLC patients.Methods：From Sep.2006 to Dec.2009,74 patients with NSCLC were treated with 3DCRT combined with concurrent chemotherapy of navelbine＋cisplatin （NP）.The side effects and clinical results were observed and recorded.Results：The leucocytopenia rate was 91.89%.Of the 74 patients,70 developed radiation pneumonitis （RP）：30 patients at grade 1,24 patients at grade 2 and 16 patients at grade 3.There was no grade 4 radiation pneumonitis.The acute radiation esophagitis results were：6 patients at grade 0,22 at grade 1,18 at grade 2 and 28 at grade 3.There were 6 patients （8.11%） in complete remission （CR） and 64 patients （86.49%） in partial remission （PR）.The median survival time was 15 months whereas the 1 and 2-year overall survival rates were 72.78% and 45.5%,respectively.Univariate analysis suggested that T staging （P=0.03）,TNM staging （P=0.0006）,weight loss or non weight loss before treatment （P=0.07） and the order of severity of radiation pneumonitis （P=0.02） had signifi cant in？ uence on survival of NSCLC.Conclusion：3DCRT combined with concurrent chemotherapy can not improve the 1 and 2-year survival rate,the unwanted side effects were also obvious in stage Ⅲ NSCLC.

关 键 词：癌 非小细胞肺 三维适形放射治疗 化学疗法 预后 

分 类 号：R734.2[医药卫生—肿瘤]