局部后程加速超分割放疗同期配合长春瑞滨加顺铂治疗Ⅲb期非小细胞肺癌  

Concurrent late-course hyperfractionated accelerated radiation therapy and combination chemotherapy with navelbine and cisplatin for stage Ⅲb non-small cell lung cancer

作　　者：张伟[1] 文浩[1] 吴双[1] 王冀川[1] 冉晓东[1] 刘燕[1] 祝玉兰[1] 杨蓉[1] 

机构地区：[1]四川省肿瘤医院放疗科

出　　处：《临床肿瘤学杂志》2002年第5期345-347,共3页Chinese Clinical Oncology

摘　　要：目的 :探讨Ⅲb期非小细胞肺癌 (NSCLC)局部小野放疗与长春瑞滨加顺铂联合化疗 (NP方案 )同步进行的临床疗效、生存质量和毒副反应。方法 :1996年 6月～ 1999年 3月 ,2 3例Ⅲb期NSCLC患者行同步放、化疗。化疗方案 :长春瑞滨 (NVB) 2 5mg/M2d1,d8;顺铂 (DDP) 30mg/M 2d1- 3,2 8天为一周期。放疗采用针对局部病变小野放疗 ,后程加速超分割方式 ,总剂量达 6 1～ 70Gy。结果 :全组病例总有效率达 86 96 % ,中位生存期 (MST) 16个月 ,1、3、5年生存率分别为 6 5 2 2 %、30 4 3%、4 35 %。骨髓抑制是主要的限制性毒副作用 ,放疗前后检测肺功能无明显改变。结论 :NP方案联合化疗加同期局部小野放疗治疗Ⅲb期NSCLC可提高疗效 ,延长中位生存期而不降低生存质量。Objective:To evaluate the efficacy of combined chemotherapy with navelbine (NVB) and cisplatin (DDP) plus concurrent local late course accelerated hyperfractionated radiotherapy in treatment of stage Ⅲb non small cell lung cancer (NSCLC).Methods:23 cases of stage Ⅲb NSCLC received combined chemotherapy regimen (NVB 25 mg/M 2 on d 1,d 8; DDP 30 mg/M 2 on day 1-3, repeated every 28 days) and concurrent late course accelerated hyperfractionated radiation therapy referring to the clinical tumor area. All patients received a dose of 40 Gy/20 F/4 WK. With conventional fractionation regimen in the first tow thirds of the course, and followed by late course accelerated hyperfractionated radiotherapy with small fields, at dose 1.5 Gy per fraction, twice daily. The total dose was 61～70 Gy.Results:The overall 1 ,3 and 5 year survival rates of the patients were 65.22%, 30.43% and 4.35% respectively. The median survival time (MST) was 16 months. The major toxicity of chemotherapy was myelosuppression and gastrointestinal tract reaction.Conclusion:This method of combined chemotherapy with NVB and DDP plus concurrent palliative local radiotherapy may improve the MST of the patients with the stage Ⅲb NSCLC.

关 键 词：Ⅲb期非小细胞肺癌 放射疗法 药物疗法 后程加速超分割照射 综合治疗 长春瑞滨 顺铂 NP方案 毒副反应 疗效 

分 类 号：R734.2[医药卫生—肿瘤] R730.[医药卫生—临床医学]