中华放射医学与防护杂志

廖安燕,王俊杰,姜玉良,等.局部晚期非小细胞肺癌放化疗综合治疗的疗效[J].中华放射医学与防护杂志,2008,28(1):69-71.LIAO An-yan,WANG Jun-jie,JIANG Yu-liang,et al.3-Dimensional conformal radiotherapy and paclitaxel radiosensitization combined with chemotherapy on locally advanced non-small cell lung cancer[J].Chin J Radiol Med Prot,2008,28(1):69-71

局部晚期非小细胞肺癌放化疗综合治疗的疗效

3-Dimensional conformal radiotherapy and paclitaxel radiosensitization combined with chemotherapy on locally advanced non-small cell lung cancer

投稿时间：2007-03-28

DOI：

中文关键词: 局部晚期非小细胞肺癌三维适形放疗紫杉醇化疗预后

英文关键词:Locally advanced non-small cell lung cancer 3-dimesional conformal radiotherapy Paclitaxel Chemotherapy Prognosis

基金项目:

作者	单位	E-mail
廖安燕	100029 北京中医药大学第三医院
王俊杰	北京大学第三医院肿瘤治疗中心	junjiew920@sohu.com
姜玉良	北京大学第三医院肿瘤治疗中心
刘江平	北京大学第三医院肿瘤治疗中心
姜伟娟	北京大学第三医院肿瘤治疗中心
李金娜	北京大学第三医院肿瘤治疗中心

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中文摘要:

目的探讨三维适形放疗联合紫杉醇化疗增敏后加化疗与未加化疗对局部晚期非小细胞肺癌治疗的疗效及不良反应。方法回顾性分析50例ⅢA和ⅢB期非小细胞肺癌的治疗方法,其中27例采用三维适形放疗联合紫杉醇化疗增敏后加化疗治疗(加化疗组);23例采用三维适形放疗联合紫杉醇化疗增敏后未加化疗治疗(未加化疗组),两组疗效及不良反应相比较。胸部三维适形放疗:3～4 Gy/次,1次/d,5次/周,共4～5周,肿瘤总剂量60～70 Gy。紫杉醇化疗增敏:在每周放疗前的周日给予紫杉醇化疗1次,剂量:30～40 mg/m²,持续3 h静滴,1次/周,共4～5周。化疗方案:紫杉醇135 mg/m²,第1、8天,静脉滴注3 h,顺铂75 mg/m²为第2～4天静脉滴注,28 d为1个周期,化疗周期为3～6个周期。结果加化疗组完全缓解率33.3%,部分缓解率55.5%,总有效率88.8%;未加化疗组完全缓解率21.7%,部分缓解率39.1%,总有效率60.8%(P<0.05)。中位生存期加化疗组为21个月,未加化疗组为16个月。1、2、3年生存率加化疗组:74.1%、40.7%和19.1%;未加化疗组:64.7%、20%和10%(P<0.05)。主要不良反应为:白细胞下降发生率加化疗组为85.2%,未加化疗组为43.5%(P<0.05);放射性肺炎发生率加化疗组为37%,未加化疗组为30.4%(P>0.05);放射性食管炎发生率加化疗组为29.6%,未加化疗组为26.1%(P>0.05)。结论联合低剂量紫杉醇化疗增敏的三维适形放疗加化疗可以提高局部晚期非小细胞肺癌的疗效,不良反应可以耐受。

英文摘要:

Objective To evaluate the efficacy and side-effect of 3-Dimensional conformal radiotherapy(3-DCRT) and paclitaxel radiosensitization combined with or without chemotherapy on locally advanced non-small cell lung cancer (NSCLC). Methods Fifty cases of stage ⅢA and ⅢB NSCLC were treated with 3-DCRT and paclitaxel radiosensitization, including 27 patients combined with chemotherapy(group 1) and 23 patients without chemotherapy(group 2). They were given chest 3-DCRT at 3-4 Gy/d for 5 d/week till a total dose of 60-70 Gy within 4-5 weeks. Before fractionated irradiaion weekly, paclitaxel chemotherapy was administered at first with the dose of 30-40 mg/m² for 3 h by infusion . The chemotherapy regimen is paclitaxel 135 mg/m² by intravenous infusion at days 1, 8 and cisplatin 75 mg/m² by intravenous infusion at days 2-4. The treatment was repeated every 28 days, up to 3-6 courses. Results The overall response rates(CR+PR) in group 1 and group 2 were 88.8% and 60.8%,respectively (P<0.05). The median survival time were 21 and 16 months in respectively. The 1-, 2-, and 3-year survival rates were 74.1%, 40.7%, 19.1%, and 64.7%, 20%, 10%, respectively (P<0.05). The main toxicities of granulo-cytopenia were 85.2% and 43.5%,repectively (P<0.05). Conclusions Weekly low dosage of paclitaxel with concurrent 3-DCRT combined with chemotherapy might be tolerable and promising in the treatment of locally advanced NSCLC.

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