EP方案联合放疗治疗局限期小细胞肺癌的临床研究

A Clinical Study of Concurrent Chemoradiation with EP Regimen in Limited Stage Small Cell Lung Cancer

目的研究EP方案联合三维适形及加速超分割放疗治疗48例局限期小细胞肺癌的疗效及不良反应。方法化疗采用EP方案，即VP-16＋DDP；放疗采用加速超分割即每周5天，每日两次，每次1．5Gy，总剂量54Gy／36F。同时采用三维适形技术。放疗在化疔的第1个疗程中第1、2周内开始。结果治疗过程中放射性肺炎发生率48％，其中Ⅲ级为4％；急性放射性食管炎发生率为：75％，Ⅲ～Ⅳ级为13％；骨髓抑制发生率为69％，Ⅲ～Ⅳ级为21％；1、2年生存率分别为88％、57％；1、2年局控率分别为89％、81％。结论EP方案联合三维适形及加速超分割放疗治疗局限期小细胞肺癌，可获得较高的局控率和生存率，而不良反应不大，可耐受，2年以上生存率有待进一步观察。

Objective To investigate the outcomes and toxicities of 46 patients with limited stage small cell lung cancer （SCLC） treated with chemotherapy combined with three dimensional conformal and accelerated hyperfraetionated radiotherapy. Methods The patients received EP regimen （eisplatin and etopide） and accelerated hyperfractionated radiotherapy： 5 days in a week, twice every day, 1.5 Gy every time, and total dose （DT） 54Gy/36F. Irradiation was performed in the first cycle of chemotherapy 1,2 weeks later. Results Radiation pneumotitis occurred in 48% （13% Grade Ⅲ,Ⅳ）,the leucopenia rate was 69% （21% Grade Ⅲ,Ⅳ ）. The 1-year, 2-year overall survival rates and local control rate were 88 %, 57 % and 89 % ,81% respectively. Conclusions EP regimen combined with three dimensional conformal and accelerated hyperfraetionated radiotherapy is acceptable in the treatment of limited stage SCLC. Both local control rate and overall survival rate have improved, but over 2-year survival rate needs further study.