序贯与同步放、化疗治疗中晚期非小细胞肺癌的疗效观察

Sequential and concurrent chemo-radiotherapy for middle and advanced stage non-small cell lung cancer

目的:比较放、化疗序贯与同步治疗非小细胞肺癌的临床疗效。方法:选择不能手术的中晚期非小细胞肺癌(NSCLC)患者62例,随机分为同步组31例和序贯组31例。化疗方案为异环磷酰胺+阿霉素+顺铂,放疗肿瘤剂量为60～65Gy。结果:(1)治疗总有效率:同步组77.42%,序贯组48.39%,两组比较有显著性差异(P<0.05);(2)达到上述有效率所用的时间前者平均69天,后者为143天,两组比较有非常显著性差异(P<0.01);(3)两组生存率方面无显著性差异(P>0.05);(4)两组病人均能耐受治疗中的不良反应。结论:同步组的近期疗效优于序贯组,且住院周期缩短减轻了患者的经济负担。该方法目前应为非小细胞肺癌治疗的最佳方法。

Objective：To evaluate the clinical effects of sequential therapy and concurrent therapy for middle and advanced stage non-small cell lung cancer（NSCLC）. Methods：62 patients with middle and advanced stage NSCLC were randomized into two groups. Sequential group：31 patients were received two cycles chemotherapy and then underwent radiotherapy ; Concurrent group：31 patients were performed radiotherapy on the fourth day in the first circle chemotherapy. The regimen of chemotherapy ： IFO ： 1 200mg/m^2 , d1-4- ADM：40mg/m^2 ,d1. PDD 25mg/m^2 ,d1-3. 21 days is one cycle. The regimen of radlotherapy：patlents were received a dose of 60-65Gy//30-33f/6-7weeks with 6 MVX-ray. Results： （ 1 ）The overall response（ CR ＋ PR） rate was 77.42% in sequential group and was 48.39% in concurrent group （P = 0. 036）. （2） The treatment course were 69 days and 143 days for sequential group and concurrent group respectively （P = 0. 008）. （3） There was no significant difference between survival rate of two groups. （4） The toxic effects can be tolerable by all of patients. Conclusions：The concurrent cbemo-radiotberapy have better overall response and shorter treatment course than the sequential chemo-radiotberapy,so it is the best method for the treatment of middle and advanced stage nonsmall cell lung cancer.