摘要
目的:评价同步放化疗(TP方案)联合恩度治疗ⅢB和Ⅳ期非小细胞肺癌的近期疗效和安全可行性。方法:60例ⅢB及Ⅳ期非小细胞肺癌患者,随机分为2组,A组(观察组)给予顺铂(25mg/m2/d,d1~d3)和紫杉醇(135mg/m2,d1)联合化疗,化疗同时使用恩度(15mg/d,d1~d14)持续泵入,共四个周期。肺部原发灶及远处转移灶进行图像引导下的适形调强放射治疗,纵隔病灶照射剂量65~70Gy,胸部非纵隔病灶照射剂量66~90Gy,淋巴结照射剂量65~70Gy。远处转移病灶进行累及野照射,颅内转移灶照射剂量70~90Gy,骨转移灶照射剂量40~55Gy,其他转移灶40~60Gy。B组(对照组)除不使用恩度外,其余治疗均与A组相同。结果:所有患者均完成治疗计划。A组:放射性食管炎13%(4例),放射性肺炎3%(1例),中性粒细胞下降67%(20例),1年生存率为50%,局部复发率为23%(7例),远处转移率为37%(11例)。B组:放射性食管炎17%(5例),放射性肺炎3%(1例),中性粒细胞下降83%(25例),1年生存率为67%,局部复发率为20%(6例),远处转移率为47%(14例)。远处转移是死亡的主要原因。结论:同步放化疗联合恩度治疗ⅢB期和Ⅳ期NSCLC安全可行,近期疗效较好,远期疗效有待进一步研究。
Objective： To evaluate the efficacy and toxicity of concomitant radiotherapy and chemotherapy combi- nating with endostatin for IIIB and IV stage non-small cell lung cancer （NSCLC）. Methods： 60 cases of IIIB and IV stage NSCLC were enrolled and randomized into two groups. Group A：30 eases with IIIB and IV stage NSCLC were treated with 4 cycles of paclitaxel （ 135 mg/m2, d1 ） , cisplatin （ 25 mg/m2/d, d1 - d3 ） and endostatin （ 15 mg/d, d1 - d14 ）. By concomi- tant radiotherapy（IGRT） ,the dose of central tumor and lymph node are the same： 65 -70Gy, peripheral tumor is 66 - 90Gy. Group B ：30 cases were treated with the same way besides endostatin. Results： All patients finished treatment. A- cute radiation-induced esophagitis was 13% and 17% , pneumonitis was 3% for the two groups, leucopenia was 67% and 83% ,the 1-year overall survival rate was 77% and 67% ,the 1-year local progression-free survival rate was 60% and 50% respectively in group A and B. Conclusion： Concomitant radiotherapy and chemotherapy combinating with endostatin for IIIB and IV stage NSCLC can be well tolerated and the toxicity is tolerable. Results of this study are encouraging, though long-term results should be followed up.
出处
《肿瘤预防与治疗》
2017年第4期265-270,共6页
Journal of Cancer Control And Treatment
基金
四川省科技厅科研项目(编号05SG022-013)
关键词
非小细胞肺癌
放化疗法
恩度
近期疗效
Non-small cell lung cancer
Chemora-diotherapy
Endostatin
Prognosis
