放疗与化疗合并放疗对113例非小细胞肺癌疗效的分析  

The difference between the effect of radiotherapy alone and that of chemoradiotherapy for 113 patients with stage Ⅲ non-small cell lung cancer

作　　者：范风云[1] 郭艳[1] 张丙芳[2] 帝新宇[2] 

机构地区：[1]第四军医大学西京医院放射治疗科,陕西西安710033 [2]第四军医大学西京医院呼吸内科,陕西西安710033

出　　处：《第四军医大学学报》2000年第8期1023-1025,共3页Journal of the Fourth Military Medical University

摘　　要：目的　评价单纯放疗与化放疗对不能手术 期非小细胞肺癌 (Non Small Cell L ung Cancer,NSCL C)的疗效 .方法　 113例不能手术的 期 NSCL C患者分为两组 :5 7例采用 CAP方案 (环磷酰胺 ,阿霉素、顺铂 )联合化疗 ,2～ 4疗程后给予放疗 . 5 6例患者接收单纯放疗 .两组的放疗方式和剂量相同 ,均采用常规分割放射 ,每次 1.8～ 2 .0 Gy,5次 / wk.原发病灶及肿瘤转移部位的总剂量 (Dose of Tum or,DT)为 6 0～ 70 Gy,淋巴引流区 DT为 5 0 Gy.结果　化放组总有效率为6 6 .7% ,完全缓解 (Com plete Response,CR)为 14.0 % ,中位生存期 13mo;单纯放疗的总有效率为 5 7.1% ,CR5 .4% ,中位生存期 8mo.两组的总有效率无差别 (P>0 .0 5 ) ,但生存期有显著差异 (P<0 .0 5 ) .化疗的副作用主要是胃肠反应及骨髓抑制 ,两组放疗的副反应相似 ,主要是放射性肺炎及肺纤维化 .结论　不能手术 期 NSCL C化放疗的 1a生存率及中位生存期优于单纯放疗 。AIM To evaluate the curative effect of radiotherapy alone and that of chemoradiotherapy for inoperable stage Ⅲ patients with non small cell lung cancer (NSCLC). METHODS 113 patients with inoperable stage Ⅲ NSCLC were divided into 2 groups. CT RT group: 57 patients received combined chemotherapy (CT) CAP regimen with cyclophosphamide, adriamycin and cisplatin. After 2 to 4 drug cycles, the patients received radiotherapy (RT). The rest of the 113 patients (56) received radiotherapy only,named RT group. The radiotherapy dose for the two groups was the same. Patients in conventional fractionation received 1.8 to 2.0 Gy/per fraction, five fractions a week, at the total dose of 60 to 70 Gy to areas of primary and lymph node involvement and 50Gy in regionally lymphatic drainage. RESULTS The overall response rates for CT RT group and RT group were 66.7% and 57.1% respectively and their complete response rates were 14.0% and 5.4% respectively. Their respective median survival periods were 13 months and 8 months. The difference between the overall response rates was not statistically significant in both groups ( P >0.05). However, there was significant difference between their survival periods ( P <0.05). The major toxic effects of chemotherapy were gastrointestinal tract reaction and myelosuppression leukopenia. The toxicity of radiation in both groups was almost the same. CONCLUSION The results suggest that chemotherapy plus radiation for inoperable stage Ⅲ NSCLC is acceptable and its survival rate of 1 year and median survival time is superior to that of radiotherapy alone.

关 键 词：非小细胞肺癌 放射疗法 药物疗法 疗效 

分 类 号：R734.205[医药卫生—肿瘤]