| 张莉,杨媚.非小细胞肺癌放化疗不同联合模式疗效、预后因素及不良反应分析[J].中华放射医学与防护杂志,2011,31(1):50-54 |
| 非小细胞肺癌放化疗不同联合模式疗效、预后因素及不良反应分析 |
| Curative effects, prognostic factors, and adverse reactions of different treatment modalities of chemotherapy in patients with non-small cell lung cancer |
| 投稿时间：2010-05-18 |
| DOI：10.3760/cma.j.issn.0254-5098.2011.01.013 |
| 中文关键词: 非小细胞肺癌 放射治疗 化学治疗 疗效 不良反应 |
| 英文关键词:Non-small cell lung cancer Radiotherapy Chemotherapy Treatment efficacy Toxicity |
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| 摘要点击次数: 2886 |
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| 中文摘要: |
| 目的 探讨放化疗不同联合模式治疗非小细胞肺癌(NSCLC)患者的疗效、不良反应,研究影响其预后的各种因素。方法 将151例经病理确诊的NSCLC患者按治疗模式不同分为3组,同步放化疗组(43例)、序贯放化疗组(49例)及单纯化疗组(59例),进行回顾性分析,评价疗效及不良反应,并分析预后因素。结果 同步放化组、序贯放化组及单纯化疗组有效率(CR+PR)分别为81.4%、73.5%、39.0%,中位生存时间分别为26、12和11个月,1年总生存率分别为80.2%、47.1%及45.6%,2年生存率分别为58.2%、38.5%及24.4%,3年生存率分别为32.7%、27.5%及0;3组不良反应主要为骨髓抑制反应,对于Ⅲ~Ⅳ级白细胞,同步放化组较单纯化疗组及序贯放化组下降明显(P<0.05);而放射性食管炎及放射性肺损伤,同步放化疗组及序贯放化疗组之间差异无统计学意义;影响NSCLC预后的主要因素有年龄、PS评分、临床分期、治疗手段。结论 同期放化疗在提高中位生存时间及生存率方面优于序贯放化疗,尤其优于单纯化疗,且不良反应可以耐受。年龄、PS评分、临床分期、治疗手段对NSCLC患者生存率有影响。 |
| 英文摘要: |
| Objective To explore the curative effects, prognostic factors, and adverse reactions of different treatment modalities of chemotherapy in patients with non-small cell lung cancer (NSCLC). Methods 151 NSCLC patients were randomly assigned into 3 groups to undergo concurrent chemo-radiotherapy (n=43), sequential chemo-radiotherapy (n=49), or pure chemotherapy (n=59). The clinical data were analyzed. Results The short-term effective rates of the concurrent and sequential chemo-radiotherapy groups were 81.4% and 73.5% respectively with no significantly difference between them, but both significantly higher than that of the pure chemotherapy group (39.0%, both P<0.05). The mortality of the concurrent chemo-radiation group was 53.5%, significantly lower than those of the sequential chemo-radiotherapy and pure chemotherapy groups (67.3% and 67.8% respectively, both P＜0.05). The median survival time of the concurrent chemo-radiotherapy group was 26 months, significantly longer than those of the sequential chemo-radiotherapy and pure chemotherapy groups (12 and 11 months respectively, both P＜0.05). The 1-year survival rates of the 3 groups were 80.2%, 47.1%, and 45.6%. The 2-year survival rates were 58.2%, 38.5%, and 24.4%, and the 3-year survival rates were 32.7%, 27.5%, and 0, respectively. The white blood cell decrease rates of the grades Ⅲ~Ⅳ of the concurrent chemo-radiotherapy group were significantly higher than those of the other 2 groups (both P<0.05). There were no significant differences in the rates of radiation esophagitis and radiation pneumonitis between the concurrent and sequential chemo-radiotherapy groups. Age, performance status score, clinical staging, and treatment modality were the 4 influencing factors in the prognosis of NSCLC (all P＜0.05). Conclusion Relatively safe with tolerable adverse reactions, concurrent chemo-radiotherapy is superior to sequential chemo-radiotherapy, particularly to pure chemotherapy, in increase of median survival time and survival rate in treatment of NSCLC. Age, PS, clinical staging and therapy method are independent indicators influencing the prognosis. |
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