局部非小细胞肺癌序列化放疗与同期化放疗对比研究  

Comparison between sequential chemoradiotherapy and concomitant chemoradiotherapy on local non-small cell lung cancer

作　　者：薛耀辉[1] 陈连生[1] 余胜珠[1] 付相建[1] 杨光华[1] 

机构地区：[1]解放军324医院中医肿瘤科,重庆400020

出　　处：《西南国防医药》2013年第2期148-151,共4页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的对于Ⅲ期不能手术的非小细胞肺癌患者,比较同期化放疗与序列化放疗生存率的差别。方法选择2007年1月～2008年1月我院收治的72例非小细胞肺癌患者,均为ⅢB期,均不愿行手术治疗。其中45例行序列化放疗,先行4周期化疗,后行肺部包块放疗;27例行同期化放疗,2周期化疗与放疗同时进行,放疗结束后再行2～3周期化疗。化疗方案均为NP方案(顺铂60 mg/m2,d 1～3;长春瑞滨25 mg/m2,d 1,8),肺部肿块放疗均采用普通放疗(6 MV照射,2 Gy/次,5次/w,共30次)。结果同期化疗组中位生存期22个月;无病存活期17个月,序列化疗组中位生存期12个月,无病存活期9个月,1年及2年生存率,同期化疗组为85.2%、66.7%,序列化疗组为48.9%、37.8%;急性食管炎及白细胞减少发生率,同期化疗组分别为29.6%、81.5%,序列化疗组为6.7%、44.4%,两组比较均有统计学差异。结论对于局部非小细胞肺癌,同期化放疗与序列化放疗相比,能显著提高疗效,但副反应相对较大。Objective To make comparison of difference in survival rate between sequential chemoradiotherapy and concomitant chemoradiotherapy on patients with stage Ⅲ non - small cell lung cancer who cannot receive the operation. Methods The subjects were 72 patients with Ⅲ B non - small cell lung cancer who were not willing to receive the operation and were admitted in our hospital from January 2007 to January 2008. Among those subjects ,45 ones received sequential chemoradiotherapy, i. e. firstly 4 cycles of chemotherapy and then radiotherapy on lung lump. Other 27 patients received concomitant chemoradiotherapy, i. e. 2 cycles of chemotherapy and radiotherapy at the same time, and after the end of the cheoradiotherapy they received another 2 - 3 cycles of chemotherapy. The chemotherapy scheme was NP pragram（60 mg/m^2 cisplatin on d 1 - 3 ;25 mg/m^2 vinorelbine on d 1 and 8 ）. The radiotherapy on lung lump was ordinary radiotherapy（ 6 MV irradiation ,2 Gy everytime ,5 times per week and totally 30 times）. Results In the concomitant chemoradiotherapy and sequential chemoradiotherapy group, the median survival time was 22 and 12 months, respectively;the disease free survival time was 17 and 9 months,respectively;the survival rates of one year to two years were 85.2%, 66.7% and 48.9% , 37.8%, respectively;the incidences of acute esophagitis and aleucocytosis were 29.6%, 81.5% and 6.7%, 44.4% ,respectively,and there were significant differences between the two groups. Conclusion On non - small cell lung cancer, concomitant chemoradiotherapy can significantly improve the curative effects but has greater side reaction compared with sequential chemoradiotherapy.

关 键 词：非小细胞肺癌 同期化放疗 序列化放疗 

分 类 号：R734.2[医药卫生—肿瘤]