摘要
目的 评估多西他赛与顺铂每周方案诱导同步放化疗联合手术在ⅢA-N2期非小细胞肺癌治疗中的有效性和安全性.方法 回顾性分析2011年3月至2013年11月18例ⅢA-N2期非小细胞肺癌患者,采用术前诱导放化疗＋手术的治疗方案.诱导化疗为DP每周方案（多西他赛20 mg/m2＋顺铂20 mg/m^2）5周期,同步放疗总剂量45 Gy;诱导治疗后非疾病进展期患者接受手术治疗;术后再给予DP方案辅助化疗.结果 16例完成诱导治疗.诱导治疗出现Ⅲ级以上不良反应5例,其中中性粒细胞减少2例,肝脏损害、淋巴结感染、贫血各1例.诱导治疗后影像学完全缓解1例,部分缓解10例,疾病稳定6例,疾病进展1例.12例患者最终接受手术,中位手术时间290 min,出血量350 ml,带管时间5天,术后住院7天.纵隔淋巴结降期率为50％（3例pN0,3例PN1）,92％的患者获得完全切除.1年生存率为75.9％,1年无进展生存率为49.2％.结论 基于多西他赛＋顺铂每周方案的诱导同步放化疗联合手术对ⅢA-N2期非小细胞肺癌患者的疗效确切,安全性良好.
Objective To evaluate the efficacy and safety of induction concurrent chemoradiation therapy with weekly docetaxel and cisplatin（DP） for stage Ⅲ A-N2 lung cancer.Methods Eighteen patients diagnosed of stage Ⅲ A-N2 NSCLC in our center were enrolled from March,2011 to November,2013.The induction regimen consisted of 5 cycles of docetaxel（20 mg/m2） and cisplatin（20 mg/m^2） administered intravenously on days 1,8,15,22 and 29 with concurrent thoracic radiotherapy in fractions of 1.8Gy,to a total dose of 45Gy.Patients proceeded to surgery,if no progressive disease occurred,followed by adjuvant chemotherapy with DP strategy.Results Eighteen patients were enrolled and 12 underwent surgery.The tumor response for the induction therapy was 1 CR,10 PRs,6 SDs and 1 PD.Five of 18 patients presented with level 3 or above adverse effects,among which were 2 neutropenia,1 liver toxicity,1 anemia and 1 lymph node infection.The median operation time was 290 min,intraoperative blood loss was 350 ml,length for postoperative drainage was 5 d,and time to discharge was 7 d.The mediastinal lymphnodedownstaging rate was 50% （3 pN0 cases and 3 pN1 ones）,92% of the operated patients reached complete resection.One-year survival was 75.9% and 1-year progression free survival was 49.2%.Conclusion Weekly docetaxel and cisplatin strategy in induction concurrent chemoradiotherapy for stage Ⅲ A-N2 NSCLC patients has been validated to be safe and effective.
出处
《中华胸心血管外科杂志》
CSCD
2015年第1期1-4,共4页
Chinese Journal of Thoracic and Cardiovascular Surgery
关键词
癌
非小细胞肺
外科治疗
抗肿瘤联合化疗方案
治疗效果
Carcinoma,non-small lung
Surgical treatment
Antineoplastic chemothrapy protocols
Treatment outcome
