放疗联合同期化疗治疗Ⅲ期非小细胞肺癌的临床研究

Radiotherapy combined with concomitant chemotherapy for stage Ⅲ non-small cell lung cancer

为了评价放疗联合同期化疗对不能手术的Ⅲ期非小细胞肺癌（non—small cell lung cancer，NSCLC）的疗效。将81例患者随机分为2组：同期放化疗组41例患者。在放疗的同时每周接受顺铂（DDP）30mg／m^2的化疗。共用6用，于第1、8天接受长春瑞滨（NVB）25mg／m^2的化疗。每3周1次；序贯放化疗组40例患者均接受NVB与DDP的诱导化疗2个疗程，然后放疗。两组放疗方法相同，每周10Gy，共60～70Gy。结果同期放化疗组和序贯放化疗组的总有效率分别为80．5％（33／41）和60．0％（24／40）．差异有统计学意义，P=0．043，完全缓解率分别是19．5％（8／41）和12．5％（6／40），差异无统计学意义，P=0．591。中位生存时间分别为15．8和13．1个月，差异有统计学意义，P=0．032。主要的不良反应是放射性食管炎、放射性肺炎与骨髓抑制，差异有统计学意义，P=0．032。初步研究结果提示，放疗联合NVB与DDP的同期化疗延长了不能手术的Ⅲ期NSCLC的生存期。

To evaluate the effect of radiotherapy combined with the concurrent chemotherapy for unreseetable stage Ⅲ non-small cell lung cancer （NSCLC）. 8 patients with unresectable stage Ⅲ NSCLC were randomized to two groups. 41 patients in the concurrent arm received weekly cisplatin （30 mg/m^2） for 6 weeks with vinorelbine （25 mg/m^2 ） on d1 and d8, every 3 weeks during concurrent radiation. 40 patients in the sequential arm received two cycles eisplatin （90 mg/m^2） on d1 and vinorelbine （25 mg/m^2） on d1 and d8 every 3 weeks followed by radiation. The method of radiation was the same in the two groups, with a dose of 60-70 Gy of radiation over 6-7 weeks. Response rate was 80. 5 % （33/41） in the concurrent arm and 60.0% （24/40） in the sequential arm. The difference in response rate between the concurrent arm and the sequential arm was significant, P=0. 043. Complete response rate was 19.5% （8/41） in the concurrent arm and 12.5 % （5/40） in the sequential arm. The difference was not significant, P= 0. 591. Median survival time was 15.8 months in the concurrent arm and 13.1 months in the sequential arm. The difference was significant, P=0. 032. The radiotherapy combined with concurrent chemotherapy is a kind of efficient treatment for patients with unresectable stage Ⅲ NSCLC.