放疗联合化疗治疗局限期小细胞肺癌的临床疗效分析  

A Study of Clinical Effects for Limited-stage Small Cell Lung Cancer Patients with Combined Modality Treatment

作　　者：刘凯[1] 张典刚[1] 谭遥[1] 王多明[1] 

机构地区：[1]新疆医科大学附属肿瘤医院放射治疗一科,乌鲁木齐830011

出　　处：《中国肿瘤临床与康复》2014年第7期826-828,共3页Chinese Journal of Clinical Oncology and Rehabilitation

基　　金：新疆维吾尔自治区科技支疆项目(201291171)

摘　　要：目的观察放疗联合化疗治疗局限期小细胞肺癌（LD-SCLC）的临床疗效，并比较不同干预方式的临床效果。方法经病理组织学证实的49例LD-SCLC，分组进行放疗联合化疗，其中EP同步组25例，顺铂40mg／m2、第1～3天，足叶乙苷100mg／d、第1～4天，化疗前2个周期同步进行放疗，同步治疗结束后继续单独进行4个周期化疗；EP序贯组24例，顺铂40mg／m2、第1～3天，足叶乙苷100mg／d、第1—4天，在4个周期化疗后开始放疗，放疗结束后继进行2个周期化疗。放疗采用调强放射治疗，剂量56～60Gy分28—30次，放疗范围为原发病灶、肺动脉、肺静脉、支气管及淋巴组织及同侧纵隔。结果EP同步组和EP序贯组的完全缓解率分别为80．0％和58．3％，1、2、3年局部控制率分别为92．0％、80．0％、48．0％和79．2％、54．2％、29．2％，3年生存率分别为32．O％和20．8％，远处转移率分别为60．0％和70．8％，组间差异均有统计学意义（P〈0．05）。两组患者近期不良反应差异无统计学意义。结论EP同步治疗LD．SCLC取得较好的临床疗效优于EP序贯治疗。Objective To evaluate the treatment effects of combined chemotherapy and radiothera- py in the limited-stage small cell lung cancer. Methods 49 patients who was cyto-pathologically diagnosed and staged as limited small cell lung cancer were made up of 40 men and 9 women, age range was 32 -71 years old （median ages 54）. The patients were divided into two groups. 25 patients （EP concurrent chemora- diotherapy） were given DDP 40mg/m2 ,dl.3 ,Vp-16 100mg/d, dr4＇ which concurrent chemoradiotherapy on first cycle, and then the fourth cycle chemotherapy after ending of radiotherapy. 24 patients were given DDP 40mg/m2,dl.3 , Vp-16 100mg/d,d14＇ which radiotherapy after four cycles chemotherapy and then given an- other two cycles chemotherapy. The radiotherapy was intensity modulated radiation therapy（ dose 56-60Gy/ 28-30f） covering the primary tumor. The ipsilateral hilar nodes and mediastinum was delivered once daily with X-ray beam to a median. Results The EP concurrent chemoradiotherapy group was super than EP se- quential group on short-term effects （ complete remission rate 80. 0%, 58. 3% ）, tumor control probability （92% , 80%, 48% vs 79. 2%, 54. 2%, 29. 2% ）, survival rate（3 years survival rate 32.0% ,20. 8% ）, distant metastasis rate（60. 0% ,70. 8% ） and there was significant difference between the 2 groups（ P 〈 0.05）. And there was no significant difference on recent untoward effect occurrence rate between two groups. Conclusion EP concurrent chemoradiotherapy get good clinical curative effect on limited-stagesmall cell lung cancer.

关 键 词：小细胞肺癌 放射治疗 药物疗法 治疗结果 

分 类 号：R734.2[医药卫生—肿瘤]