摘要
目的比较依托泊苷联合顺铂(EP)不同周期放射治疗局限期小细胞肺癌(limited-stage small cell lung cancer,LS-SCLC)患者的获益及耐受情况。方法纳入病理证实的LS-SCLC患者120例,随机分为A、B 2组各60例,分别在EP方案化疗第1周期、第2周期时联合放疗。A组:VP-16 120mg/m2 d1、d2、d3,顺铂60mg/m2d1,每3周1个周期,共4个周期,于第1周期同步放疗,放疗剂量为3周45GY(1.5GY,2次/d);B组:VP-16 120mg/m2 d1、d2、d3,顺铂60mg/m2 d1,每3周1个周期,共4个周期,于第2周期同步放疗,放疗剂量为3周45GY(1.5GY,2次/d)。各组用药前30min常规静脉滴注格拉司琼、地塞米松等药物以减轻化疗反应。观察指标为缓解率(response rate,RR)、疾病控制率(disease control rate,DCR)、无进展生存时间(progression free survival,PFS)、不良反应及循环血肿瘤细胞(circulat-ing tumor cells,CTC)数目。结果 2组RR和DCR差异无统计学意义(P>0.05),A组PFS和总生存时间长于B组(P<0.05)。A组食管炎发生率明显高于B组(P<0.05),2组白细胞减少、贫血、血小板减少发生率差异无统计学意义(P>0.05)。治疗后A组CTC≥1、CTC≥5、CTC≥10和CTC≥50比例较治疗前明显减少(P<0.05),B组CTC≥10和CTC≥50比例较治疗前明显减少(P<0.05),CTC≥1和CTC≥5比例与治疗前差异无统计学意义(P>0.05);A组CTC≥5、CTC≥10比例少于B组(P<0.05),CTC≥1、CTC≥50比例与B组差异无统计学意义(P>0.05)。结论 EP方案第1周期联合同步放疗临床受益优于EP方案第2周期联合放疗。
Objective To compare the benefits and tolerance of radiotherapy patients with limited-stage small cell lung cancer(LS-SCLC)in different EP cycles,and to explore the timing of radiotherapy.Methods The patients with limited stage small cell lung cancer confirmed by pathology were randomly divided into two groups.Group A:VP-16 120 mg/m2 d1,2,3,cisplatin 60 mg/m2 d1,every 3 weeks for 1 cycles,a total of 4 cycles.In first cycles of concurrent radiotherapy,radiotherapy dose and schedule:45 GY(1.5 GY,bid)for three weeks.Group B:VP-16 120 mg/m2 d1,2,3,cisplatin 60 mg/m2 d1,every 3 weeks for 1 cycles,a total of 4 cycles.In second cycles of concurrent radiotherapy,radiotherapy dose and schedule:45 GY(1.5 GY,bid)for three weeks.Each group received intravenous granisetron and antiemetic therapy 30 minutes before the treatment.The observation indexes were remission rate(RR),disease control rate(DCR),progression free survival(PFS),and the adverse reactions of circulating tumor cells(CTC)number.Results The RR and DCR of group A and group B were not statistically significant(P>0.05).The PFS and average survival time of group A were longer than gruop B,the difference was statistically significant(P<0.05).In the adverse reactions,the incidence of esophagitis in group A was significantly higher than that in group B(P<0.05),and the incidence of leukopenia,anemia and thrombocytopenia were similar in both groups,and the incidence of esophagitis in group A was significantly higher than that in group B(P >0.05).CTC was measured in fourth cycle,the number of CTC in group A was significantly lower than that before chemotherapy(P<0.05),the number of CTC in patient with CTC≥10 and CTC≥50 is significantly lower than befor in gruop B,but the number of CTC in patient with CTC≥1 and CTC≥5 was not lower than before(P>0.05).The number of CTC≥5 and CTC≥10 in group A was less than that in group B(P<0.05).There was no significant difference between CTC≥1 and CTC≥50 in group A(P> 0.05).Conclusion The EP regimen of the first cycle comb
出处
《河北医科大学学报》
CAS
2018年第2期133-136,141,共5页
Journal of Hebei Medical University
基金
张家口市科技计划自筹经费项目(1521065D)
关键词
小细胞肺癌
化放疗
治疗结果
small cell lung carcinoma
chemoradiotherapy
treatment outcome
