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  

Clinical effects and safety evaluation of concurrent radiochemotherapy with Parlitaxel and Cisplatin to treat locally advanced non-small cell lung cancer

作　　者：时明宇[1] 

机构地区：[1]沈阳市第五人民医院放疗科,110023

出　　处：《中国疗养医学》2016年第5期462-464,共3页Chinese Journal of Convalescent Medicine

摘　　要：目的 探讨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 选择2012-03—2015-03沈阳市第五人民医院放疗科收治的62例局部晚期非小细胞肺癌患者,临床分期Ⅲb期24例,Ⅳ期38例,将患者随机分为观察组与对照组,每组各31例。对照组放疗方案：放疗剂量2.0 Gy/d,5次/周,疗程为6周。观察组放化疗方案：在对照组的放疗方案基础上给予患者紫杉醇注射液135 mg/m2配比500 m L质量浓度为0.05 g/m L的葡萄糖,及顺铂75 mg/m2配比质量浓度为0.009 g/m L的氯化钠静滴,于化疗第1周、第4周静滴,治疗后按RECIST标准对肿瘤客观疗效进行评价,根据世界卫生组织（WHO）抗癌药物急性与亚急性毒副反应标准对患者不良反应进行评价。结果 依据RECIST标准,对比两组患者治疗后的疗效,观察组总有效率为87.1%明显高于对照组的74.2%,组间差异具有统计学意义（P〈0.05）。治疗中出现的主要不良反应为白细胞减少、血小板减少、血红蛋白减少、腹泻、恶心呕吐、脱发、肌肉关节疼痛,对比两组患者发生不良反应的情况发现,观察组并发症白细胞减少、血小板减少、血红蛋白减少、恶心呕吐、关节疼痛的Ⅲ~Ⅳ级发病率分别为19.4%（6/31）、16.1%（5/31）、6.5%（2/31）、35.5%（11/31）、22.6%（7/31）,对照组分别为6.5%（2/31）、3.2%（1/31）、3.2%（1/31）、22.6%（7/31）、6.5%（2/31）,观察组明显高于对照组,差异具有统计学意义（P〈0.05）,腹泻、脱发发病率两组比较差异无统计学意义（P〉0.05）,无其他严重不良反应,两组患者均全部完成治疗,无中途退出者。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疗效更好,但有较重的不良反应,应视患者的实际病情选择治疗方案。Objective To study the clinical effects and safety evaluation of concurrent radiochemotherapy with Pacli- taxel and Cisplatin to treat locally advanced non-small cell lung cancer.Methods 62 sufferers with locally advanced non-small cell lung cancer admitted to Radiotherapy Department of Shenyang No.5 People＇s Hospital from March 2012 to March 2015, among which there were 24 cases of clinical stage Ⅲb and 38 cases of clinical stage Ⅳ ,were select- ed and randomly divided into observation group and control group with 31 cases in each group.Radiotherapy plan for the control group：Radiotherapy dose 2.0 Gy/d,five times/week,one treatment course of 6 weeks.Radiotherapy plan for the observation group：Based on the radiotherapy plan for the control group, there was additional Paclitaxel injec- tion of 135 mg/m2 and 500 mL glucose with mass concentration of 0.05 g/mL, and Cisplatin of 75 mg/m2 and Sodium Chloride drip with mass concentration of 0.009 g/mL, for intravenous injection in the 1st and 4th week.After treat- ment, RECIST criteria were adopted to evaluate the objective curative effect of tumor, and WHO anti-cancer drug a- cute and subacute toxic and side effect criteria were adopted to evaluate the adverse reactions among the sufferers. Results The curative effect by RECIST criteria showed the total effective rate of 87.1% in the observation group was clearly higher than 74.2% in the control group, with differences of statistical significance （P〈 0.05）.During treatment, the main adverse reactions included leucopenia, thrombocytopenia, decreased hemoglobin, diarrhea, nausea and vomit- ing, hair loss, and muscle arthralgia.Comparison of adverse reactions in both groups showed in the observation group the morbidity of leucopenia, thrombocytopenia, decreased hemoglobin, nausea and vomiting, and muscle arthralgia Ⅲ- Ⅳ was respectively 19.4%（6/31）, 16.1%（5/31）,6.5%（2/31）,35.5%（11/31）,and 22.6%（7/31）,while in the control group it was 6.5%（2/31）,3.2%（1/31）,3.2%（1/31）,22.

关 键 词：紫杉醇 顺铂 同步放化疗 晚期非小细胞肺癌 

分 类 号：R734.2[医药卫生—肿瘤]