放化疗联合治疗对Ⅳ期非小细胞肺癌的疗效对比研究  

Efficacy of chemoradiotherapy in the treatment of stage Ⅳ non-small cell lung cancer

作　　者：鹿凯[1,2] 尤庆山[2] 

机构地区：[1]大庆油田总医院,黑龙江大庆163001 [2]哈尔滨医科大学附属第三医院,黑龙江哈尔滨150081

出　　处：《现代肿瘤医学》2013年第8期1768-1772,共5页Journal of Modern Oncology

摘　　要：目的:探讨三维适形放射治疗(3-dementional conformal radiation therapy,3D-CRT)在Ⅳ期非小细胞肺癌中的临床应用,为晚期非小细胞肺癌患者,特别是老年、伴有内科疾病及一般状况差的病人提供安全、有效的治疗方法。方法:回顾性分析我院2007年12月-2010年12月258例初诊经组织学或细胞学证实的Ⅳ期非小细胞肺癌患者。根据治疗方式不同分三组:单纯放疗组、单纯化疗组、放化联合组进行对照。结果:单纯放疗组、单纯化疗组、放化联合组中位生存时间分别为9个月、11个月和13个月;0.5年生存率为75.8%、71.8%和85.1%;1年生存率为29.8%、40.5%和56.4%;2年生存率为9.1%、12.3%和14.5%;近期有效率分别为57.6%、42.0%、64.9%;进展率分别为48.5%、49.6%、40.4%;中位无进展时间分别为6个月、7个月、9个月。放疗与化疗结合并未增加化疗的毒副反应(P>0.05)。结论:3D-CRT联合化疗应用于Ⅳ期非小细胞肺癌,较单纯化疗和单纯放疗提高了中位生存期和0.5年、1年、2年生存率,而并未增加毒副反应;对老龄、合并内科疾病、一般状况差的病人单纯精确放疗也取得了比较理想的效果。Objective：To evaluate the clinical effect of patients with stage Ⅳ non-small cell lung cancer（NSCLC） treated with three dimensional conformal radiation therapy（3D-CRT）.Methods：From 2004 to 2007,258 patients with stage Ⅳ NSCLC confirmed pathologically treated with radiotherapy,chemotherapy and chemoradiotherapy were restrospectively analyed.Results：The median survival time was 9 months in group 1,1 1 months in group 2 and 1 3 months in group 3.The half-year,1 and 2 year survival rates were 75.8%,29.8% and 9.1% in group 1,71.8%,40.5% and 12.3% in group 2 and 85.1%,56.4% and 14.5% in group 3.The complete and partial response rate was 57.6% in group 1,42.0% in group 2 and 64.9% in group 3.The progression rate was 48.5% in group 1,49.6% in group 2 and 40.4% in group 3.Median progression-free survival time was 6 months in group 1,7months in group 2,9 months in group.The treatment toxicity were not increased（P 0.05）.Conclusion：The patients with stage Ⅳ non-small cell lung cancer treated with 3D-CRT combined with chemotherapy could improve CR and PR rate,the median survival time and 0.5,1,2 year survival rates.The treatment toxicity was not increased.The patients treated with 3D-CRT simply could get good results,especially for the patients with physical diseases,the elderly and the low general situation.

关 键 词：Ⅳ期 非小细胞肺癌 化疗 三维适形放射治疗 

分 类 号：R734.2[医药卫生—肿瘤]