放化疗结合射频消融治疗局部晚期非小细胞肺癌的临床疗效  

Chemoradiotherapy combined with radiofrequency ablation in locally advanced non-small cell lung cancer

作　　者：崔林[1] 陈珏[1] 刘建军[1] 钱厚龙[1] 刘兴祥[1] 姜勇[1] 陈高阳[1] 吴兴军[1] 何学军[1] Cui Lin;Chen Jue;Liu Jianjun;Qian Houlong;Liu Xingxiang;Jiang Yong;Chen Gaoyang;He Xuejun(Department of Oncology,Taizhou Second People's Hospital,Jiangsu Taizhou 225500,China)

机构地区：[1]泰州市第二人民医院肿瘤科,江苏泰州225500

出　　处：《现代肿瘤医学》2018年第6期884-887,共4页Journal of Modern Oncology

基　　金：江苏大学医学临床科技发展基金资助(编号:JLY20160162)

摘　　要：目的:研究放化疗加射频消融治疗局部晚期非小细胞肺癌的临床疗效。方法:76例非小细胞肺癌随机分为两组,观察组采用放化疗加射频消融,以单纯放化疗作为对照,两组分别统计近期疗效、治疗副作用、生存质量、生存时间。结果:观察组40例,有效率(RR)65.0%,疾病控制率(DCR)77.5%,对照组RR30.6%,DCR 55.6%,两组比较差异有统计学意义(P<0.05)。总生存时间(OS)观察组(1 5.8±2.6)个月,对照组(13.4±2.3)个月(P=0.146),其中IIIa期观察组(18.9±2.8)个月,对照组(15.2±2.6)个月(P=0.039),IIIb期观察组(14.2±1.9)个月,对照组(12.3±1.7)个月(F=2.971,P=0.091)。无病进展时间(PFS),观察组(9.9±2.8)个月,对照组(8.7±2.2)个月(P=0.366);其中IIIa期观察组(11.8±3.6)个月,对照组(8.9±3.4)个月(P=0.044),IIIb期观察组(8.1±1.2)个月,对照组(6.4±1.5)个月(P=0.182)。二组治疗后生活质量好转率在IIIa期比较无差异,在IIIb期比较差异有统计学意义(P=0.035)。治疗副作用主要为化疗相关毒副反应,RFA主要为咯血、痰中血丝、发热、气胸,经对症处理缓解。结论:射频消融结合放化疗可以延长IIIa期NSCLC病人的OS、PFS,可以改善IIIb期病人的生活质量。Objective:To evaluate the curative effect and safety of chemoradiotherapy combination with radiofrequency ablation in locally advanced non-small cell lung cancer.Methods:According to the researching principles,76 matched patients were randomly devided into two arms,the observation group(OG)and the control group(CG).In the OG,chemoradiotherapy and radiofrequency ablation were used synergisticly while in the CG ablation was absent.Results:In the OG(40 cases),response rate(RR)was 65.0%,disease control rate(DCR)was 77.5%,while those were 30.6%and 55.6%respectively in CG.A signficant difference was found between the two groups(P=0.006,P=0.041).The common side-reactions were associated with the chemotherapy and RAF.Hemoptysis,bloody spatum,faver and aerothorax were occasionally observed and could be corrected using corresponding treatments.In OG,the mean overall-survival was(15.8±2.6)months,it was(18.9±2.8)months in III a patients and(14.2±1.9)months in III b patients.As the control,the mean OS was(13.4±2.3)months,it was(15.2±2.6)months in III a subgroup and(12.3±1.7)months in III b subgroup.Only III a patients in OG showed a survival advantage compared with those III a patients in CG(P=0.039).[KG(*9]In OG,progression free survival(PFS)was(11.8±3.6)months in III a patients and(8.1±1.2)months in III b patients,the mean PFS was(9.9±2.8)months.In CG,PFS was[KG)](8.9±3.4)months in III a patients and(6.4±1.5)months in III b patients,the mean PFS was(8.7±2.2)months.Only patients with III a staging in OG showed a PFS advantage(P=0.044).Quality of life(QOL)was improved in two groups.However,only III b patients received synergistic treatment showed significant improvement in QOL(P=0.038).Conclusion:RAF combination with chemoradiotherapy can prolong OS and PFS in lung cancer patients with III a staging and improve the QOL in patients with III b staging.

关 键 词：非小细胞肺癌 放疗 化疗 射频消融 

分 类 号：R734.2[医药卫生—肿瘤]