摘要
目的:观察三维适形放疗(3DCRT)联合吉西他滨和顺铂同步化疗治疗局部晚期非小细胞肺癌的近期疗效及副反应。方法:84例Ⅲ期非小细胞肺癌患者(Ⅲa期49例,Ⅲb期35例)随机分为两组:单纯三维适形放疗组(RT组)42例,GP方案联合三维适形放疗组(RT+C组)42例。两组放疗方法相同,三维适形放疗,2Gy/次,5次/周,总剂量DT60Gy-70Gy,6-7周完成。RT+C组在放疗开始每周一次吉西他滨300mg/m2 iv drop d1,顺铂20mg/m2 iv drop d1,共4-6周。结果:近期临床疗效:RT+C组CR6例(14.3%),PR30例(71.4%),有效率(CR+PR)85.7%;RT组CR3例(7.1%),PR19例(45.2%),有效率(CR+PR)52.4%,RT+C组的CR及有效率均高于RT组,差异有显著性。RT+C组,放射性肺炎发生率为23.8%(10/42),放射性食管炎发生率为35.7%(15/42),白细胞下降发生率为83.3%(35/42),均比RT组高。84例患者的中位随访期为18个月。结论:三维适形放疗联合吉西他滨和顺铂同步治疗局部晚期非小细胞肺癌近期疗效较好,毒性反应有所增加,但可以耐受,远期疗效有待进一步随访。
Objective：To study the efficacy and toxicity of concurrent gemcitabine plus cisplatin combined with three- dimensional conformal radiotherapy for stage Ⅲ non -small cell lung cancer（ NSCLC ）. Methods： Eighty - four patients pathologically diagnosed as NSCLC （ Ⅲ a： 49cases, Ⅲ b- 35 cases ） were divided randomly into two groups,radiotherapy（3DCRT） alone （42 cases ） and radiation plus chemotherapy （GP） group. There was no differ- ence of radiotherapy between the two groups, 3DCRT received a total dose of 60Gy - 70Gy ,2 Gy per fraction, 5 times every week, about 6 -7 weeks. The RT ＋ C cases accepted GP regimen during the radiation, and DDP once weekly injection of vain, according to 20mg/m^2 and gemcitabine once weekly iv according to 300mg/m^2. These regimen were given for 4 -6weeks. Results： The early outcome ：the complete remission rate was 14.3% and partial remission rate was 71.4% in RT ＋ C. the complete remission rate was 7.1% and partial remission rate was 45.2% in RT. The totalresponse rate and complete remission of RT ＋ C group were higher than that of the RT group. There was significant difference between the two groups. Acute radiation - pneumonia, acute radiation - esophagitis and leukocytopenia rates were 23.8 % （ 10/42 ）, 35.7 % （ 15/42 ） and 83.3 % （ 35/42 ）, respectively, higher than that of the RT group. The median follow- up duration was 18.4 months. Conehmion： Concurrent gemcitabine and eisplatin combined with three - dimensional conformal radiotherapy for stage Ⅲ non - small cell lung cancer is well tolerated and with good immediate tumor response in most patients, and the adverse effects was raised,but can be tolereated.
出处
《现代肿瘤医学》
CAS
2008年第4期562-564,共3页
Journal of Modern Oncology
关键词
非小细胞肺癌
三维适形放疗
化疗
吉西他滨
顺铂
预后
non - small cell lung cancer
three - dimensional conformal radiotherapy
chemotherapy
gemcitabine
cisplatin
prognosis
