超分割放疗结合同期化疗治疗Ⅲ期非小细胞肺癌的临床研究  

Hyperfractionated radiation therapy with concurrent low-dose weekly carboplatin/etoposide for stage Ⅲ non-small-cell lung cancer:a randomized study

作　　者：罗辉[1] 钟军[1] 熊建萍[2] 徐建华[1] 康恭礼[1] 刘明之[1] 龚小昌[1] 汤轶强[1] 邬蒙[1] 

机构地区：[1]江西省肿瘤医院放疗科,江西南昌330029 [2]江西医学院第一附属医院,江西南昌330006

出　　处：《现代肿瘤医学》2004年第1期28-30,共3页Journal of Modern Oncology

基　　金：江西省卫生厅基金资助;项目编号 (199940 )

摘　　要：目的　评价放化疗同步与放化序贯 2种方法治疗Ⅲ期非小细胞肺癌 (NSCLC)的疗效及毒副反应。方法　对 6 0例ⅢA/ⅢB期NSCLC患者随机分成放化疗同时进行组 (治疗组 )和放化疗序贯进行组 (对照组 )。治疗组放疗采用超分割方法 ,每次 1 2Gy,2次 /天 ,间隔 4～ 6h ,5天 /周 ,总剂量为 6 9 6Gy。化疗采用卡铂 10 0mg +VP - 16 10 0mg ,每周 1次 ,共 5～ 6周。对照组放疗采用常规放射治疗方法 ,每次 2Gy ,每天 1次 ,每周 5天 ,共 6周 ,总剂量为 6 0Gy ,化疗於放疗前和 (或 )放疗后 1个月进行 ,采用MVP方案 (MMC10mg第 1天 ,VDS3mg/m2 第 1～ 3天 ,DDP30mg/m2 第 1～ 3天 ) 2周期。结果　治疗组总有效率为 72 4 % ,对照组总有效率为 6 3 3% ( 19/30 ) ,其中CR 6 7% ( 2例 ) ,PR 5 6 7% ( 17例 ) ,治疗组与对照组总有效率比较无显著性差异 (P >0 0 5 )。治疗组患者放射性食管炎、骨髓抑制、及胃肠反应发生率分别为 79 3% ( 2 3/2 9)、72 4 % ( 2 1/2 9)、75 9% ( 2 2 /2 9) ,均高于对照组的 30 0 % ( 9/30 )、4 6 7% ( 14 /30 )、33 3% ( 10 /30 ) ,均有显著性差异 (P <0 0 1、P <0 0 5、P <0 0 5。)治疗组中位生存期显著高于对照组。Objective To investigate the efficacy of concurrent hyperfractionated radiation therapy(HFX RT) and low-dose weekly chemotherapy(CHT) in stage Ⅲ non-small cell lung cancer(NSCLC).Methods Between March 1998 and November 2001,60 patients with histologically or cytologically confirmed stage Ⅲ NSCLC.(KPS)≥70,and no previous treatment were randomly treated as folllows:HFX RT/CHT concurrent group, HFX RT with 1.2 Gy twice daily to a total dose of 69.6 Gy and concurrent CHT consisting of 100mg of Carboplatin and 100mg of Etoposide given on each RT week (n=29);and conventional radiotherapy plus CHT group (n=30);conventional RT with 60 Gy/30f/6 week CHT consisted of two cycles of 10mg Mitomycin on day1, Vindesine 3mg/m 2 on day1 to day3 and Cisplatin 30mg/m 2 on 3 days 3.Results HFX RT/CHT concurrent group had a significantly longer survical time than the control group, with a median survical of 18 versus 15 months( P =0.0391) and showed higher incidence of acute toxicity than the control group( P <0.05),but no treatment-related death toxicity. Conclusion The combination of HFX RT and low-dose weekly Carboplatin plus Etoposide is tolerable and improve the survical of patients with stage Ⅲ NSCLC.

关 键 词：超分割放疗 化疗 治疗 Ⅲ期非小细胞肺癌 NSCLC 肿瘤 

分 类 号：R734.2[医药卫生—肿瘤]