放化疗同步治疗Ⅲ期非小细胞肺癌

Concomitant Chemotherapy and Radiotherapy for Inoperable Stage 3 Non-small Cell Lung Cancer

目的:评价放射治疗合不同化疗方案的治疗不能手术的ш期非小细胞肺癌(NSCLC)疗效.方法:62例不能手术的ш期NSCLC患者随机分为2个组;29例化疗组每周接受1次紫杉醇30mg,顺铂30mg化疗(紫杉醇组),33例为对照组.连续5～6周,均同时配合常规分割放射冶疗(2Gy/次,5次/周),照射野包括肺部原发灶和纵隔淋巴引流区,总剂里为60～70Gy.结果:紫杉醇组总有效率(CR+PR)为82.8%,完全缓解(CR)率为10.3%,对照组总有效率为54.6%,CR率为18.0%.2个组总有效率差异有显著性意义(X2=4.41 p=0.038).中位生存期1、2年生存率紫杉醇组分别为12.8个月,52.2%、27.3%,对照组分别为9.8个月、42.8%、18.4%,2个组差异无显著性意义.化疗的毒副作用主要是骨髓抑制和消化道反应,但均可耐受.结论:紫杉醇组绐疗不能手术的3期NSCLC近期有效率明显优于单放组,但不提高生存率.

Objective: To evaluate the effect of concomitantdifferent regimens chemotherapy and radiotherapy for inoperable stage 3 non-small cell lung cancr (NSCLC),Methods Fron September 1998 to December 2000,62 patients winth inoperable stage 3 NSCLC were randomized into groups.Method:Nine patients received paclitaxel 30mg and cisplain 30 mg weekly for 5～6 weeks(paclitaxel group ),and 33 patients was control group.All patients received concomitant radiotherapy as well.Radiotherapy was given withconventional fraction in 2 Gy per fraction and five fractions per week .The total tumor doses were 60～70Gy .Treatment fields covered clinical umor and lymph node invlolved .Result: The overall response (CR+PR) rate in paclitaxel group was 82.% with a coplete response (CR) rate of 10.3%.The overall response rate in the control group was 54.6%with a CR rate of 18% .The difference of overall response rate between the two groups was statistically significant (P<0.05) the median survival time ,1-,and 2-year survival rates were 12.8monthe ,52.2%and 27.2%for paclitaxel group ,and 9.8 months ,42.8% and 18.4% for the control group(P>0.05).the major toxic effects of chemotherapy were gastrointestinal tract reactine and myelosuppression .Conclusion: Concomitant chemotherapy of paclitaxel plus cisplatin and radiotherapy for inoperable stage 3 NSCLC is acceptable ,and its efficacy is superior to radiotherapy alone.