摘要
目的探讨常规剂量多疗程同步放化疗治疗晚期非小细胞肺癌的疗效和不良反应。方法184例Ⅲ期非小细胞肺癌患者随机分为3组,放疗组61例,采用常规放疗为前后野照射,40GY后缩野加量,肿瘤灶总剂量60GY。有淋巴结转移者照射60GY;化疗组60例,采用紫杉醇联合顺铂常规剂量化疗6周期,28天为1周期;同步放化疗组63例,化疗开始的第8天进行放疗,方法同上两组,直至疗程结束。结果同步放化疗组、放疗组、化疗组有效率分别为76.2%、62.3%、56.7%,化疗组与同步放化疗组比较差异有统计学意义(χ2=5.27,P=0.021),放疗组与同步放化疗组比较差异无统计学意义(χ2=2.82,P=0.094)。同步放化疗组、放疗组、化疗组的1、2、3年生存率分别为68.2%、43.3%、19.0%,51.5%、20.5%、7.8%,54.0%、28.8%、10.1%,中位生存期分别为18、12、13个月。化疗组、放疗组与同步放化疗组比较差异有统计学意义(χ2=6.26,P=0.039)。同步放化疗组不良反应比较大,但可以耐受。结论常规剂量6周期紫杉醇联合顺铂同步放化疗,能明显提高晚期非小细胞肺癌患者的有效率和生存率,不良反应有所加重,但不影响治疗的正常进行。
Objective To evaluate the efficacy and toxicity of concurrent radiotherapy and chemotherapy in the treatment of advanced non - small cell lung cancer (NSCLC). Methods Total 184 patients with stage Ⅲ NSCLC were divided randomly into three groups, the radiotherapy (RT) group, the chemotherapy (CT) group, and the radiotherapy + chemotherapy ( RT + CT) group. 61 cases in the RT group received regular radiotherapy, the total dose was 60 Gy in the local site and the metastatic lymph nodes. 61 cases in the CT group recievd paclitaxel plus cisplatin regimen,the chemotherapy was repeated every 28 days and the period of treatment included 6 therapy . 63 cases in the RT + CT group recievd concurrent radiotherapy and chemotherapy, the radiotherapy started in the 8th day after chemotherapy, and the treatment regimens were same to the RT group and the CT group. Results The effective rates in the RT + CT, RT and CT group were 76. 2% ,62.3 amd 56. 7% respectively, there was a significant difference between the CT group and the RT + CT group ( χ^2 = 5. 27, P = 0. 021 ). But there was no significant difference between the RT group and the RT + CT group( χ^2 = 2.82, P =0.094) . the 1 , 2 and 3 year survival rates in the RT+CT,RT and CT group were 68.2% ,43.3%, 19.0% ;51.5% ,20. 5% ,7.8% ; 54. 0%, 28.0%, 10. 1% respectively, the median survival time in the three groups were 18,12 and 13 months,and the significance was different among them ( χ^2 = 6. 26, P = 0. 039). the concurrent radiotherapy and chemotherapy had more toxicities than the others, but the side effects were well tolerated. Conclusion Paclitaxel combined with cisplatin chemotherapy plus standard radiotherapy can significantly improve the effective rate and survival rate for the patients with advanced non - small cell lung cancer. Although the toxicities increase, the treatment was completed after the expectant administration.
出处
《医药论坛杂志》
2009年第3期3-5,共3页
Journal of Medical Forum
关键词
癌
非小细胞肺癌/放射疗法
癌
非小细胞肺癌/化学疗法
同步放化疗
预后
Carcinoma, non - small cell lung/radiotherapy
Carcinoma, non - small cell lung/chemotherapy
Concurrent chemo - radiotherapy
Prognosis