羟基喜树碱用于放疗增敏治疗局部晚期非小细胞肺癌的临床研究

The Clinnical Research on 10-Hydroxycamplothecin (HCPT) for Radiosensitization on Local Advanced Non-small Cell Lung Cancer

目的:对比羟基喜树碱(HCPT)用于放射增敏合并放疗与常规放疗治疗局部晚期非小细胞肺癌的客观疗效及其毒副作用。方法:60例晚期非小细胞肺癌患者随机分为两组,每组30例。试验组:采用常规分割放射治疗,总剂量60～70Gy/30～35f,6～7周完成。放疗第一天给HCPT(8mg/m2)化疗增敏,每周两次,疗程同放射治疗,放疗后给予HP(羟基喜树碱加顺铂)方案巩固化疗4周期。对照组:同试验组放射治疗。结果:试验组近期有效率和1年局控率、1年生存率均显著高于对照组,1年远处转移率显著低于对照组,差异有显著性(P<0.05);毒副反应的发生以骨髓抑制和消化道反应最为明显,试验组显著高于对照组,但多为轻度,未影响疗程进行。结论:羟基喜树碱用于放射增敏治疗局部晚期非小细胞肺癌是一种安全有效的治疗方法,值得进一步临床研究。

Objective： To compare the efficacy and toxicity of HCPT between radiosensitive agents with conventional radiotherapy （RT） and conventional RT alone. Methods： Sixty patients with stage NSCLC were divided randomly into two groups, i.e. the experiment group and the controls. In the experimental group, all patients were treated by conventional fractional radiotherapy with a total dose of 60-70Gy/30-35f/6-7w. HCPT （8mg/m^2） was given intravenously with NS 500ml within an hour after the RT, twice a week for 6 to 7 weeks and chemotherapy of HP（HCPT＋DDP） was given for 4 cycles. In the Contrast group, all patients were given to a total dose of 60-70Gy with conventional RT. Results： The short-term overall response rate and the 1-year locoregional control rate, as well as survival rate of the experimental group were significantly higher compared to the controls. The 1- year distant metastasis rate of the experimental group much lower than that of the contrast group, and there was a significant difference between the 2 groups （P〈0.05）. The more common side-effects were myelosuppression and the symptom of gastrointestinal tract in the experimental group was much higher compared to the control. There was a significant difference between the 2 groups （P〈0.05）. But most of the reactions in experiment group were grade and , and there was no impact on the treatment. Conclusion： HCPT, as radiosensitivity agent plus radiotherapy, is safe and effective for local advanced NSCLC. It is worthy of doing further clinical investigation.