摘要
目的观察EP化疗方案与超分割放疗同步治疗局限期小细胞肺癌的近远期疗效及不良反应。方法足叶乙苷（VP-16）100mg静脉滴注（第1-5天）；顺铂（PDD）70mg／mg／（第1天）；21d为1个周期，完成至少2个周期的化疗。同步组患者的放疗与第1个周期化疗同步进行。1．2Gy／次，2次／d，总量45Gy；序贯组患者的放疗在2个周期化疗完成后开始，方法及剂量同前。结果同步治疗组患者的肿瘤进展时间与序贯组患者比较有显著性差异，但总生存期、1-3年生存率及平均生存期两组相似。同步组患者发生向细胞、血小板下降及严重放射性食管炎的比例高于序贯组，但无显著性差异。结论EP方案与超分割放疗同步进行治疗局限期小细胞肺癌较序贯治疗有一定优势且不良反应可耐受。
Objective To evaluate the efficacy of EP regimen delivered concurrently with hypedractionated irradiation for locally small cell long cancer. Methods 40 patients were randomly assigned to either concurrent or sequential chemoradiotherapy.The treatment was composed of at least 2 cycles of EP regimen chemotherapy every 3 weeks （VP-16 100 mg was administrated intravenously on day 1-5 and cisplatin 70 mg/nf on day 1）.Hyperfractianated thoracic radiotherapy was begun on day 1 of the first cycle of chemotherapy in the concurrent arm and after the second eycle in the sequential arm.Radiotherapy was administered twice daily （1.2 Gy per fraction with 6 hours between fractions）and directed to the primary tumor for a total dose of 45 Gy in 3 weeks. Results Concurrent chemoradiotherapy had shown better survival than sequential chemoradiotherapy （P=0.965 by log-rank test）, especially in time of tumor progession（TTP）（P=0.048）.The median survival time was 18.3 months in the concurrent arm versas 17.1 months in the sequential arm.The 1-,2-and 3-year survival rate for patients who received concurrent therapy was 70%,25%and 15% respectively versus 73.7%,21% and 5.3% in the sequential arm respectively.Hematologlc toxicity and esophagitis Were more severe in the concurrent arm. Conclusions This study suggests that Ep regimen and concurrent hyperfractionated radiotherapy are more effective and well tolerated than the sequential chemoradiotherapy.lt should be studied further.
出处
《结核病与胸部肿瘤》
2006年第2期94-97,共4页
Tuberculosis and Thoracic Tumor
关键词
癌
小细胞
化学疗法
放射疗法
综合疗法
Carcinoma, small cell Radiotherapy Chemotherapy Combined modality therapy
