生物反应调节剂加放化疗治疗非小细胞肺癌  

Biological response modifiers combined with radiotherapy and chemotherapy for stage Ⅲ non-small-cell lung cancer

作　　者：李华峰[1] 赵敏[1] 丁纪元[1] 

机构地区：[1]杭州第四人民医院肿瘤科,浙江杭州310002

出　　处：《中国癌症杂志》2001年第6期507-509,共3页China Oncology

摘　　要：目的 :评价生物反应调节剂 (BRMS)治疗局部晚期非小细胞肺癌 (Ⅲ期NSCLC)的临床价值和毒副反应。方法 :5 9例Ⅲ期NSCLC病人随机分两组 ,2 9例进入放化疗组 ,30例进入生物治疗 +放化疗 (BRMS)组。放化疗组 :行 6MV X线胸部常规放疗 ,照射范围包括原发灶、纵隔、肺门 ,锁骨上淋巴结转移加照锁骨上。肿瘤剂量6 0— 6 5Gy ,42— 45天完成。放疗前后各化疗 2个疗程 ,鳞癌用EP方案。腺癌或腺鳞癌应用MVP方案。BRMS组放化疗顺序剂量与放化疗组相同 ,在第 2个化疗结束后应用γ干扰素 (γ IFN) ,白细胞介素 2 (IL 2 )交替皮下注射。γ IFN 10 0万U 日第 1、3、5天 ,IL 2 2 0— 5 0万U 日第 2、4、6天皮下注射。 6天为 1周期 ,共 8个周期。结果 :近期疗效 :放化疗组完全缓解 (CR) 10 .3%(3 2 9) ,部分缓解 (PR)占 41.4%(12 2 9) ,总有效率 (CR +PR) 5 1.7%。BRMS组完全缓解 (CR)占 16 .6 5 %(5 30 ) ,部分缓解 (PR)占 6 0 %(18 30 ) ,总有效率 76 .6 %。两组相比有显著差异 (χ2 =4.0 1,P <0 .0 5 )。一、二年生存率放化疗组为 6 2 .1%、17.3%,中位生存时间 13.3个月。BRMS组为 83.3%、43.3%,中位生存时间 2 0 .4个月 (两组一年生存率相比 χ2 =3.37,P =0 .0 8;两组的二年生存率相比 χ2 =4.74,P <0 .0 5 )。结?Purpose:To evaluate the effect of biological response modifiers for Ⅲ stage non-small-cell lung cancer.Methods:Fifty-nine patients were randomized into two groups.Twenty-nine patients were put into radiotherapy and chemotherapy(R+C) groups,thirty patients were into Biological response modifiers and radiotherapy chemotherapy(BRMS+R+C) groups.All patients received routine radiotherapy 2.0 Gy per day,5times a week to a total dose of 60-65 Gy,in 42-45 days.Radiation fields just covered clinical tumors.Chemotherapy consisted of cisplatin 25-30 mg/m 2 ,etoposide 50-70 mg/m 2 on days 1?2and 3 every 4 week,for squamous cell carcinoma.For adenocarcinoma,it was mitemycin 4-6 mg/m 2 on day1 and vindesine 3 mg on day1 and8,and cisplatin25-30 mg/m 2 on day1?2 and 3,every 4 weeks interferon-γ(IFN-γ)and interleukin-2(IL-2)were used in(BRMS+R+C)groups after the second chemotherapy was over. IFN-γ was given on days 1?2?3 and IL-2 on days 2?4?6 to a total of forty-eight day.Results:The overall response rate was 51.7% and 76.6% in(R+C) and(BMRS+R+C) groups.The one.two year survival rates were 62.1% 17 3% and 83 3%,43 3% in (R+C) and (BMRS+R+C) groups respectively.Conclusions:The preliminary results from our study has shown that biological response modifiers combined with radiotherapy and chemotherapy for non -small cell lung cancer has better early response rate and survival rate.

关 键 词：非小细胞肺癌 生物治疗 放射治疗 化学治疗 综合治疗 生物反应调节剂 

分 类 号：R734.2[医药卫生—肿瘤] R730.5[医药卫生—临床医学]