MVP化疗同步结合放疗治疗晚期非小细胞肺癌的临床疗效

Efficacy of MVP chemotherapy combined with concurrent radiotherapy for advanced non-small cell lung cancer

目的 评价MVP(丝裂霉素、长春地辛和顺铂 )方案化疗同步结合放疗治疗晚期非小细胞肺癌的临床疗效。方法 62例由细胞学或病理证实、初治、KPS评分 60分以上、预计生存时间 3个月以上的ⅢB期或Ⅳ期非小细胞肺癌患者 ,采用信封抽签法分为放化疗组和MVP组各 3 1例。两组患者都接受MVP化疗 ,丝裂霉素 6mg/m2 静脉注射 ,第 1天 ;长春地辛 2mg/m2 静脉注射 ,第 1、8天 ;顺铂 80～ 10 0mg/m2 静脉滴注。每三周重复。放化疗组放射治疗与化疗同时进行 ,照射剂量为 46～ 5 6Gy/5～ 6周。 结果 两组患者接受化疗 2～ 4个周期。放化疗组和MVP组有效率分别为 48.4% (15 /3 1)和 19.4% (6/3 1) (P <0 .0 5 ) ,中位肿瘤进展时间分别为 8个月和 4个月 (P <0 .0 5 ) ,中位生存时间分别为 10个月和 6个月 (P <0 .0 5 ) ,1年生存率分别为 5 4.8% (17/3 1)和 2 2 .6% (7/3 1) (P <0 .0 5 )。放化疗组的骨髓毒性重于MVP组 ,有显著性差异 (P<0 .0 5 ) ;胃肠道反应等两组无显著性差异 (P >0 .0 5 )。结论 MVP化疗同步结合放疗治疗晚期非小细胞肺癌 ,较单纯化疗更能有效地控制肿瘤进展、延长患者的生存时间 ,毒副作用可以耐受。

Objective To observe the effects of MVP chemotherapy combined with concurrent radiotherapy for stage ⅢB--Ⅳ non-small cell lung cancer. Methods Sixty-two patients with stage ⅢB--Ⅳ non-small cell lung cancer were randomized into two groups, concurrent radiochemotherapy group and MVP che-motherapy group. All patients in two groups were treated with MVP regimen (mitomycin C 6 mg/m 2 on day 1, vindesine 2 mg/m 2 on days 1, 8, and cisplatin 80--100 mg/m 2). Patients in concurrent radiochemotherapy group received concurrent radiotherapy (46--56 Gy in 5--6 weeks). Results All patients received 2--4 cycles of MVP chemotherapy. The response rate was 48.4% and 19.4% in concurrent radiochemotherapy group and MVP group respectively (P<0.05), the 1-year survival rate was 54.8% and 22.6% respectively (P< 0.05), median time to progression was 8 months and 4 months respectively (P<0.05), and median survival duration was 10 months and 6 months respectively (P<0.05). Incidence of grade Ⅱ--Ⅲ leukopenia in concurrent radiochemotherapy group was remarkably higher than those in MVP group. Conclusion The results show that efficacy of MVP chemotherapy combined with concurrent radiotherapy is significantly higher than that of MVP chemotherapy alone for advanced non-small cell lung cancer.