摘要
目的:比较后程化疗与放疗同步(后程同步化放疗)和序贯化放疗治疗Ⅲ期非小细胞肺癌的疗效及不良反应。方法:2002年2月～2006年10月间洛阳市中心医院肿瘤科86例Ⅲ期非小细胞肺癌患者随机分为两组:后程同步化放组42例与序贯化放组44例。1)后程同步化放组:先行2个周期不含紫杉醇(T)或多西紫杉醇(D)的化疗方案,再给予2个周期的T(或D)P每周方案,与放疗同步进行,具体为紫杉醇90mg/m^2或多西紫杉醇37.5mg/m^2,d_(1,8),顺铂25mg/m^2,d_(2-4),21天为1个周期。2)序贯化放组:先行4个周期化疗(含或不含紫杉醇或多西紫杉醇),化疗后再给予放疗。两组放疗方法及剂量相同,均先前后对穿再行三维适形照射。结果:后程同步化放组和序贯化放组的近期有效率分别为83.3%、54.5%(P<0.05),中位生存期分别为19个月和18个月(P>0.05);后程同步化放组的急性放射性肺炎发生率为11.9%,明显低于序贯化放组的29.5%(P<0.05);后程同步化放组的血液学毒性较序贯化放组明显,但以重组人粒细胞集落刺激因子支持均能完成治疗。结论:后程化疗同步放疗可提高Ⅲ期非小细胞肺癌的近期疗效,可减少急性放射性肺炎的发生率,提高远期生存质量。
Objective： To compare the effects and toxicities of late-course concurrent chemoradiation therapy and sequential chemoradiation therapy for stage Ⅲ non-small cell lung cancer （NSCLC）. Methods： From February 2002 to October 2006, 86 patients with stage Ⅲ NSCLC were divided into two groups. There were 42 patients in the late-course concurrent chemoradiation （LCCR） group who received two cycles of chemotherapy （not including Paclitaxel/Docetaxel in the regimen） and then underwent concurrent chemoradiation therapy （Paclitaxel 90mg/m^2 or Docetaxel 37.5mg/m^2 on dl and d8, Cisplatin 25mg/m^2 on d2, d3, and d4. One cycle was 21 days, and two cycles were administered）. In the sequential chemoradiation （SCR） group the 44 patients received four cycles of chemotherapy （with or without Paclitaxel/Docetaxel）, and then underwent radiotherapy. All patients received the circa para-prick shoot and then underwent three-dimensional conformal radiotherapy. Results： The short-term response rate was 83.3% in the LCCR group and 54.5% in the SCR group （P〈0.05）. The median survival time was 19 months and 18 months, respectively （P〉0.05）. The toxicity rate of acute radiation-induced pneumonitis was 11.9% in the LCCR group and 29.5% in the SCR group （P〈 0.05）. The hematologic toxicity in the LCCR group was more serious than that in the SCR group, but all the treatments were finished after administration of rHuG-CSF （Recombinant Human Granulocyte Colony Stimulating Factor）. Conclusion： Late-course concurrent chemoradiation therapy can improve short-term response, reduce the rate of acute radiation-induced pneumonitis and improve the future quality of life.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2009年第15期865-867,共3页
Chinese Journal of Clinical Oncology
关键词
非小细胞肺癌
后程化疗与放疗同步
序贯化放疗
急性放射性肺炎
Non-small cell lung cancer
Late-course concurrent chemoradiation therapy
Sequential chemoradiation therapy
Acute radiation-induced pneumonitis
