三维适形放疗联合吉非替尼治疗局部晚期肺腺癌的临床观察  

Clinical Observation of Gefitinib plus Three Dimensional Conformal Radiotherapy for Local Advanced Lung Adenocarcinoma

作　　者：周绍兵[1] 刘阳晨[1] 高飞[1] 

机构地区：[1]江苏省泰兴市人民医院放疗科,江苏泰兴225400

出　　处：《临床医学工程》2012年第12期2087-2088,共2页Clinical Medicine & Engineering

基　　金：泰州市311工程人才基金项目(201032)

摘　　要：目的观察吉非替尼联合适形放射治疗局部晚期肺腺癌的疗效及不良反应。方法 70例局部晚期肺腺癌患者随机分为吉非替尼联合适形放射治疗组(治疗组)和单纯适形放射治疗组(对照组)各35例。放疗采用6MVX线三维适形放射治疗,2.0Gy/次,1次/d,5次/周,DT66～72Gy。治疗组同步口服吉非替尼,从放疗第1天开始,连服2月。胸部病灶按WHO实体瘤疗效评价标准在放疗30天内经胸部增强CT扫描评价近期疗效,急性副反应及晚期并发症按照RTOG标准进行评价。结果治疗组有效率(CR+PR)为88.6%,对照组有效率为62.9%,两组有效率比较,差异有统计学意义(χ2=6.29,P<0.05);治疗组1、2、3年生存率分别为65.7%、37.1%、22.9%,对照组1、2、3年生存率分别为40.0%、14.3%、5.7%,两组同期生存率比较,差异均有统计学意义(χ2=4.64、4.79、4.20,P<0.05)。吉非替尼组主要不良反应为Ⅰ/Ⅱ度皮疹、腹泻。结论吉非替尼联合适形放射治疗局部晚期肺腺癌能提高患者的生存率,并未增加毒性反应。Objective To evaluate the efficacy and adverse effects of gefitinib combined with three dimensional conformal radiotherapy （3DCRT） for local advanced lung adenocarcinoma. Methods Seventy patients with local advanced lung adenocarcinoma were randomly divided into two groups. Thirty-five patients received gefitinib plus 3DCRT （treatment group）, thirty-five patients received 3DCRT （control group）. All patients were given with 6MV X-ray, 2.0 Gy per fraction, once a daily. The total dose varied from DT 66 Gy to 72 Gy. Gefitinib was administered concurrenthy with radiotherapy in escalating doses, from the first day of RT to two months. The short-term effect was evaluated by enhanced chest CT scan within 30 days of radiotherapy according to WHO Solid Tumors Response Evaluation Criteria, acute side effects and advanced complications were evaluated according to RTOG criteria, Results The effective rate （CR ＋ PR） in the treatment group was 88.6%, and 62.9% in the control group, the difference of effective rate between the two groups was statistically significant （χ2 = 6.29, P 〈0.05）; 1-, 2-, and 3-year survival rates were 65.7%, 37.1%, 22.9% in the treatment group and 40.0%, 14.3%, 5.7% in the control group （χ2 = 4.64, 4.79, 4.20; P 〈0.05）. Conclusions Gefitinib plus 3DCRT can increase the survival rate in patients with local advanced lung adenocarcinoma without severe toxicities.

关 键 词：肺腺癌 吉非替尼 三维适形放射治疗 

分 类 号：R730.55[医药卫生—肿瘤]