MVP方案及同步放疗治疗老年Ⅲ期肺鳞癌近期疗效观察  

A comparative study of concurrent thoracic radiotherapy in combination with mitomycin, vindesine and cisplatin in stage Ⅲ lung squamous cancer in elders

作　　者：朱宇熹[1] 王昱[2] 陈绪元[1] 

机构地区：[1]重庆医科大学附属第一医院肿瘤科,400016 [2]第三军医大学西南医院儿科,重庆400038

出　　处：《重庆医学》2003年第6期712-714,共3页Chongqing medicine

摘　　要：目的　前瞻性研究长春花碱酰胺 (VDS)、丝裂霉素 (MMC)、顺铂 (DDP)联合化疗方案与放射治疗 (radiotherapy ,RT)同步治疗Ⅲ期老年肺鳞癌患者的疗效。方法　收治Ⅲ期肺鳞癌 6 0例 ,随机分为研究组及对照组。研究组 30例予常规RT ,同时给予MVP方案化疗 2疗程 ,从第 1疗程化疗的第 2天起开始RT ;对照组 30例患者接受单纯RT。两组的RT方法相同 ,总剂量6 0Gy,常规分割。RT结束后两组都予MVP方案化疗 4疗程。结果　RT结束后 ,研究组的有效率为 80 % ;对照组的有效率为6 3.3% ,组间有显著性差异 (P <0 .0 5 )。所有化疗结束后研究组有效率为 86 .7% ,对照组有效率为 80 %。中位生存期研究组18.2月 ,对照组 16 .1月 ,总 1年生存率研究组 76 .7% ,对照组 6 6 .6 % ,1年无进展生存率研究组 5 0 % ,对照组 33.3%。治疗的副反应主要是骨髓抑制、食管和肺炎 ,研究组重于对照组 ,Ⅲ、Ⅳ度白细胞下降率共为 4 6 .7% ,Ⅲ、Ⅳ度血小板下降率共为 2 0 % ,研究组 16例患者放化疗期间因副反应延误时间超过 5d。对照组无Ⅳ度骨髓抑制 ,Ⅲ度白细胞下降率为 16 .7% ,Ⅲ度血小板下降率为6 .7%。结论　MVP同步放化疗加辅助化疗治疗Ⅲ期老年肺鳞癌患者 ,有效率高于单纯RT加MVP方案辅助化疗 ,1年生存率和1年无进展生存率也优势 ,毒?Objective To investigate the feasibility of concurrent thoracic RT and combination chemotherapy with mitomycin (MMC) vindesine (VDS) and cisplatin (DDP) in the management of lung squamous cancer in elders.Methods A total of sixty eld patients with Ⅲ stage lung squamous cancer were randomized into study group and control group. Patients of study group were treated with 2 cycles of MVP regimen and concurrent thoracic RT began on the day 2 of the first cycle of chemotherapy. Patients of control group were treated with thoracic RT. The dose of RT was 60 Gy. All patients were treated with four cycles of MVP regimen sequentially. Results The response rate (RR) of study group and control group were 80% and 63.3% ( P <0.05), respectively. After all the adjuvant chemotherapy were finished, the RR of study group and control group were 86.7% and 80% and the overall median survival time of the 2 groups were 18.2 months and 16months, respectively. The total 1 year survival rates were 76.7% and 66.6%, respectively. The 1 year progression free survival rates were 50% and 33.3%, respectively. The main side effects of the trial were leukopenia, thrombocytopenia, and esophagitis. Grade 3 or 4 leukopenia and thrombocytopenia were observed in 46.7% and 20% patients of study group, respectively. Delay in study group (>5 days) was observed in 16 patients. There were no Grade 4 leukopenia and thrombocytopenia in control group.Grade 3 leukopenia and thrombocytopenia were in 16.7% and 6% patients, respectively.Conclusion A higher RR is attainable in Ⅲ stage lung squamous cancer of elder patients treated with MVP regimen and concurrent thoracic RT and adjuvant chemotherapy than RT and adjuvant chemotherapy. The 1 year survival rate and 1 year no progression rate are also better. It is possible to administer two courses of chemotherapy in study group as planned. It is benefit to the clinical treatment.

关 键 词：肺鳞癌 老年 放射治疗 化疗 长春花碱酰胺 

分 类 号：R734.2[医药卫生—肿瘤]