诱导化疗加三维适形放疗治疗局部晚期非小细胞肺癌疗效分析

Induction chemotherapy combined with three-dimensional conformal radiation ther a py for locally advanced non small cell lung cancer

目的 评价诱导化疗加三维适形放疗(3DCRT)治疗局部晚期非小细胞肺癌(NSCLC)的疗效及并发症。方法 92例局部晚期NSCLC患者随机分为单纯3DCRT组(RT组5 0例)和诱导化疗与3DCRT联合组(CMT组4 2例)。CMT组在3DCRT治疗前给以2～4个疗程铂类为主的化疗。结果 全组中位总生存期15个月,RT组中位总生存期12个月,CMT组18个月(P =0 .0 14 )。1年生存率RT组为4 8.6 % ,CMT组为71.2 % (P =0 .0 0 4 ) ,2年生存率RT组为2 0 .8% ,CMT组为37.6 % (P =0 .0 4 1)。两组毒副反应相似,患者均能耐受。结论 诱导化疗加三维适形放疗治疗晚期NSCLC可延长生存期,但并不增加放射副反应。

Objective To evaluate the effect and complication of inductio n chemot herapy combined with three-dimensional conformal radiation therapy (3DCRT) for l ocally advanced non small cell lung cancer (NSCLC). Methods Ninety-two such pa t ients were randomized into radiation therapy alone group(RT-, 50 patients) and i nduction chemotherapy combined radiotherapy group (CMT-, 42 patients). The indu c tion chemotherapy consisted of 2-4 cycles of platinum-based regimen. Results Th e overall median survival time was 15 months with 12 months in the RT group and 18 months in the CMT group(P=0.014)respectively. The 1-year o verall survival rates were 48.6% and 71.2% in RT and CMT group,respectively (P=0.004). The 2-year survival rates w ere 20.8% and 37.6% in RT and CMT group, respectively (P=0.0 41). Treatment was w ell tolerated and the toxicities were similar in either group. C onclusion The ad dition of induction chemotherapy to 3DCRT takes a survival advantage over 3DCRT alone for Stage Ⅲ NSCLC without increasing toxicities.