超分割放疗合并化疗治疗局部晚期非小细胞肺癌疗效观察

Analysis of hyperfration radiotherapy combined with chemotherapy for local advanced non-small cell lung cancer

目的:比较超分割放疗合并化疗与常规放疗治疗局部晚期非小细胞肺癌的疗效和毒副反应。方法:70例经病理证实的ⅢA～ⅢB期患者(排除恶性胸腔积液),随机分成治疗组和对照组。治疗组先行EP-CP方案化疗1疗程,再行超分割放疗,放疗剂量:超分割放疗1.1Gy/次,2次/d,总剂量66～70.4Gy/60￣62Fx/(6～6.5w)。对照组采用60Co常规放疗,放疗剂量:60～64Gy/30～32Fx/(6～6.5w)。结果:治疗组、对照组有效率分别是74.2%(26/35),48.5%(17/35),P<0.05,1年存活率分别是60.0%(21/35),48.6%(17/35),P>0.05,3年存活率分别是31.4%(11/35),14.4%(4/35),P<0.05。两组骨髓抑制,消化道反应,放射性肺炎毒副反应相似。结论:化疗结合超分割放疗治疗局部晚期非小细胞肺癌能提高疗效,延长生存期,患者耐受性好。

Objective To compare the effects and radiation toxicities of hyperfraction radiotherapy combined with chemotherapy and conventional fraction radiotherapy for local advanced non-smaU cell lung cancer （NSCLC）. Method Seventy pathologically proved ⅢA～ⅢB were divided randomly into two groups： one is treatment group, in which chemotherapy EP-CP （Etoposide, Carboplatin）was givens first, then patients received hyperfraction radiotherapy, 1.1Gy/f bid, with a more than 6 hours interval, 10 fraction per week, To a total dose of 66～70.4Gy/60～62Fx/6w～6.5w. Two is control group in which patients received conventional fraction radiotherapy, to the total dose of 60Gy～64Gy/30～32f （6～6.5w）. Results The local free rate in treatment groups was 74.2% （21/35）,and that of control group was 48.5 % （17/35） （P〈0.05）.The 1 year survival rates in treatment group and control group were 60.0% （21/35）,48.6% （17/35）, （P〉.05）, the 3year survival rates were 31.4%（11/35）,14.4%（4/35）, （P〈0.05） respectively. The Toxic side-effects of gastrointestinal tract reaction myelosuppression and radiation pneumonitis were similar in two groups. Conclusion Hyperfraction radiotherapy combined with chemotherapy can improve the local control rate and survival rate of patients with local advanced non-smaU cell lung Cancer, The side-effects were tolerable.