不同放化疗模式治疗中晚期非小细胞肺癌的疗效分析  

The Analyses of Curative Effect of Different Chemo-radiotherapy Modes in the Treatment of Advanced Non-small Cell Lung Cancer

作　　者：孟玲楠[1] 石砂硼 林珊[1] 高纯子[1] 韩波[1] 

机构地区：[1]哈尔滨医科大学附属第一医院肿瘤二科,黑龙江哈尔滨150001 [2]哈尔滨工程大学医院内科,黑龙江哈尔滨150001

出　　处：《现代生物医学进展》2016年第29期5658-5662,共5页Progress in Modern Biomedicine

基　　金：黑龙江省卫生厅科研课题(2012-547)

摘　　要：目的:探讨同步和序贯放疗联合不同化疗方案对治疗中晚期非小细胞肺癌近期疗效、远期生存及毒性反应的影响。方法:将45例III-IV期非小细胞肺癌患者随机归入两组,同步放化疗组22例;序贯放化疗组23例。全组病例依据病情分别选择艾素和顺铂、吉西他滨和顺铂、长春瑞滨和顺铂或培美曲塞和顺铂方案化疗。比较两组近期疗效、远期生存率及毒性反应。结果:同步组近期有效率为81.8%高于序贯组73.9%,但无统计学差异(P>0.05);两组均有随放疗剂量增加有效率升高趋势。NP和TP方案两组近期疗效相近(P>0.05)。同步组和序贯组1年生存率分别为90.9%和86.9%(P<0.05);2年生存率分别为72.7%和52.2%(P>0.05)。毒性反应主要为骨髓抑制、放射性食管炎和肺炎。同步组毒副反应发生率高于序贯组,但无统计学差异(P>0.05)。结论:同步放化疗治疗中晚期非小细胞肺癌近期疗效及远期生存率有优于序贯放化疗的趋势,但毒副反应发生相对增多。联合治疗模式下,分期越早,患者远期生存时间越长。近期疗效有随放疗剂量增高而提高趋势,但放疗剂量、病理类型、化疗方案等对患者远期生存无明显统计学差异。Objective： To explore the effect of short-term efficacy, the long-term survival rate and the toxicity in the treatment of advanced non-small cell lung cancer with different chemotherapy regimens combined with concurrent radio-chemotherapy and sequential radio-chemotherapy. Methods： 45 patients of non-small cell lung cancer were randomized into two groups, which included 22 cases re- ceiving concurrent radio-chemotherapy and 23 cases receiving sequential radio-chemotherapy. All patients were given chemotherapy with Vinorelbine and Cisplatin（NP）, Gemcitabine and Cisplatin（GP）, Taxotere and Cisplatin（TP） or Pemetrexed disodium and Cisplatin （PP） regimens. Short-term efficacy, the long-term survival rate and the toxicity were compared between two groups. Results： The effec- tive rate of the concurrent radio-chemotherapy group （81.8% ） was higher than that of the sequential radio-chemotherapy group （73.9%） （P〉0.05）. The effective rates were improved with the radiotherapy dose increasing in both groups. The NP and TP regimens have the sim- ilar effective rates （P〉0.05）. The 1 year survival rate in the concurrent radio-chemotherapy group and sequential radio-chemotherapy group were 90.9% and 86.9%（P〈0.05）, and 2 year survival rate were 72.7% and 52.2%（P〉0.05）. The toxicity in both groups were myelo- suppression, radiation esophagitis and radiation pneumonitis. And the concurrent radio-chemotherapy group was higher than sequential radio-chemotherapy group（P〉0.05）. Conclusions： In the treatment of advanced non-small cell lung cancer, concurrent radio-chemothera- py maybe better than sequential radio-chemotherapy, but the toxicity was significantly increased. The long-term survival rate was posi- tively correlated with the stage. The effective rates were improved with the radiotherapy dose, but the radiotherapy dose, pathological type, chemotherapy regimens and so on had no significant differences to the long-term survival rate of the patients.

关 键 词：非小细胞肺癌 同步放化疗 序贯放化疗 

分 类 号：R734.2[医药卫生—肿瘤]