奥利沙铂、多西紫杉醇化疗方案联合同步三维适形放疗治疗晚期非小细胞癌的近期临床疗效观察  

Clinical Observation on Oxaliplatin Plus Docitaxel Combined with Concurrent Three Dimensional Conformal Radiotherapy in Treatment of Patients with Limited Advanced Non-small Cell Lung Cancer

作　　者：刘飞[1] 贾鑑慧[1] 孙丽萍[1] 祝沈冬[1] 段宏燕[1] 段晨阳[2] 

机构地区：[1]辽宁省肿瘤医院放疗科,辽宁沈阳110042 [2]解放军第三军医大学 临床医学系,重庆400038

出　　处：《现代生物医学进展》2014年第7期1315-1319,共5页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(30872464)

摘　　要：目的:观察并探讨奥利沙铂(Oxaliplatin,L-OHP)与多西紫杉醇(Docetaxel,DXL)化疗方案联合同步三维适形放疗(three dimensional conformal radiotherapy,3DCRT)治疗晚期局限性非小细胞肺癌(non-small cell lung cancer,NSCLC)的近期临床效果并安全性。方法:将2010年1月-2012年2月间入选的94例局限性NSCLC患者随机单盲分为观察组(48例)与对照组(46例),观察组给予L-OHP、DXL化疗方案并联合同步3DCRT治疗方案,对照组予3DCRT治疗方案,对比两组治疗后临床疗效、生命质量改善情况及治疗期间毒副反应。结果:①两组患者疗效构成不同,观察组完全缓解率(12.5%)与总有效率(81.3%)均高于对照组(6.5%、58.7%),且后者差异具有统计学意义(X2=5.713,P=0.017);②观察组、对照组治疗后生活质量改善比例分别为56.6%、33.3%,两组生活质量具有显著性差异(Z=-2.101,P=0.036);③治疗期间观察组、对照组分别死亡2例(4.2%)、1例(2.2%),观察组骨髓抑制、胃肠道反应、末梢神经损害、放射性肺损伤发生率高于对照组(P<0.05)。结论:L-OHP与DXL化疗联合同步3DCRT放疗治疗NSCLC可提高后者对原发病灶的近期控制率、改善患者生活质量,但也应注意对联合放化疗期间出现毒副反应的对症处置。Objective： The The paper is to observe on recent clinical efficacy and toxicity reaction of Oxaliplatin （L-OHP） plus Docitaxel （DXL）combined with concurrent three dimensional conformal radiotherapy（3DCRT） in treatment of patients with limited adva nced non-small cell lung cancer （NSCLC）. Methods： Prospective study was conducted on 94 admitted NSCLS patients from Jan. 2010 to Feb.2012, and 94 cases were randomized into observation （n=48） ＆ control group （n=46）, observation group was applied with L-OHP plus DXL combined concurrent 3DCRT scheme, and control group was only treated with 3DCRT regime, during and after which clinical efficacy, quality of life improvement,toxic ＆ side reactions were compared between 2 groups. Results： ①2 groups with different clinical efficacy, complete remission rate ＆ total efficiency rate of observation group were higher than those of control group （12.5%VS.6.5%, 81.3%VS. 58.7%）, and the difference of total efficacy rate was statistically significant （X^2=-5.713, P=0.017）.②Quality of life with obvious improvement of observation ＆ control group were 56.6%, 33.3% respectively, and there was significant difference （ Z= -2.101, P=0.036 ）.③During treatment, Observational group had seen 2（4.2%） death cases, while control group with 1（2.2%）, death case during treatment, incidence rate ofmyelosuppression, gastrointestinal tract reaction, peripheral nerve damage, radiation induced lung injury in observation group was higher than that of control group （ P 〈 0.05 ）. Conclusion： L-OHP plus DXL chemotherapy combined with concurrent 3DCRT radiotherapy in treatment of limited advanced NSCLC can improve recent control rate of primary lesion, and also enhance patients＇ life quality, but attention also should be paid to strengthening symptomatic disposal for reactions occured during combination of radio-chemo therapy.

关 键 词：三维适形放疗 奥利沙铂 多西紫杉醇 疗效 生活质量 毒副反应 

分 类 号：R734.2[医药卫生—肿瘤]