紫杉醇联合顺铂同步放化疗治疗局部晚期非小细胞肺癌的临床疗效及安全性评价  

Paclitaxel combined with cisplatin concurrent chemo-radiation for the treatment of locally advanced non-small cell lung cancer

作　　者：王宝强[1] 周陈华[1] 

机构地区：[1]丽水市人民医院放疗科,浙江丽水323000

出　　处：《中国临床药理学杂志》2015年第8期603-605,共3页The Chinese Journal of Clinical Pharmacology

基　　金：浙江省丽水市科技局科学研究基金资助项目(20038409)

摘　　要：目的评价紫杉醇联合顺铂同步放化疗治疗局部晚期非小细胞肺癌的临床疗效及安全性。方法将63例局部晚期非小细胞肺癌患者随机分为试验组30例和对照组33例。对照组给予放疗,放疗总剂量为60 Gy,2.0 Gy·d^-1,每周放疗5次,共6周。试验组在对照组的基础上,第1,4周给予紫杉醇135mg·m^-2和顺铂70 mg·m^-2静脉输注化疗2个周期。放疗疗程结束2周后,评价2组的临床疗效及不良反应发生率。结果试验组客观反应率（76.7%）显著高于对照组（45.5%）,差异有统计学意义（P〈0.05）;试验组中位生存时间为16.4个月,1年生存率72.1%;对照组中位生存时间为13.2个月,1年生存率为52.0%,试验组中位生存时间显著长于对照组（风险比为0.54,P〈0.05）。试验组Ⅲ-Ⅳ级粒细胞减少5例（16.7%）,恶心呕吐8例（26.7%）;对照组Ⅲ-Ⅳ级粒细胞减少1例（3.0%）,恶心呕吐4例（12.1%）,试验组不良反应发生率（43.3%）显著高于对照组（15.2%,P〈0.05）。结论紫杉醇联合顺铂同步放化疗治疗局部晚期非小细胞肺癌可延长患者中位生存时间,但不良反应发生率较高。Objective To evaluate the clinical effects and safety of paclitaxel combined with cisplatin concurrent chemo-radiation in the treatment of locally advanced non-small cell lung cancer.Methods A total of 63 patients with locally advanced non-small cell lung cancer were recruited from January 2012 to June 2014 in our hospital.The involved 63 cases were randomly divided into experiment group（30 cases） and control group（33 subjects）.The patients in the control group were treated by regular radiation under 60 Gy dosage（2 Gy·d^-1,5 times per week for 6 weeks）.Patients in the experiment group were administered with paclitaxel 135 mg·m^-2combined with cisplatin 70 mg·m^-2by intravenous drip at the 1^stand 4^thweek of radiation.The objective response rate,median survival time and adverse reactions of the two groups were compared after treatment.Results The objective response rate was76.7% and 45.5% in the experiment and control group with significant difference（P〈0.05）.The median survival time in experiment group（16.4 months） was much higher than that in control group（13.2months）（HR = 0.54,P〈0.05）.The incidence of grade Ⅲ-Ⅳadverse reactions in control group（43.3% vs 15.2%） was much higher than those in experiment group,such as granulopenia（5 vs 1） as well as nausea and vomiting（8 vs 4）（P〈0.05）.Conclusion Paclitaxel combined with cisplatin concurrent chemo-radiation can improve the median survival time of patients with non-small cell lung cancer,but significantly increasing incidence of adverse reactions.

关 键 词：紫杉醇 顺铂 局部晚期非小细胞肺癌 放疗 预后 

分 类 号：R734.2[医药卫生—肿瘤] R979.1[医药卫生—临床医学]