放疗联合化疗治疗不可手术局部晚期非小细胞肺癌

Chemoradiotherapy for unresectable locally advanced non-small cell lung cancer

目的 比较长春瑞宾／顺铂（NP方案）联合同步放疗对局部晚期非小细胞肺癌（NSCLC）的疗效与安全性。方法 60例ⅢA或ⅢB期NSCLC患者接受NP＋同步放化疗（同步组）或MVP／VP方案＋序贯放疗（序贯组）。放疗剂量范围在40～66Gy。结果 序贯组有效率为33％，明显低于同步组的63％；两组中位生存期相似。同步组47％患者出现不同程度的放射性食管炎症状，明显高于序贯组的13％；Ⅲ／Ⅳ食管炎在同步组为20％。结论 低剂量NP方案化疗联合同步胸部放射一线治疗局部晚期NSCLC有效，患者可以耐受。

Objective To evaluate the effects and toxicity of concurrent chemoradiotherapy with the regimen of vinorelbine/cisplatin in locally advanced non-small cell lung cancer （NSCLC）. Methods Sixty cases stage Ⅲ A or Ⅲ B NSCLC patients randomly received concurrent chemofadiotherapy with the regimen of vinorelbine/cisplatin （concurrent group） or sequential chemoradiotherapy with the regimen of mitomycin/ vindesin/cisplatin or vindesin/cisplatin （sequential group）. The radiotherapy dose was between 40 and 66 Gy. Results The response rate in sequential group was 33 %, which was significantly lower than 63% in concurrent group. The median survival terms were similar in the two groups. About 47% of the patients in concurrent group developed esophagitis,more often than in that sequential group, 13 %. The incidence of grade 3/4 esophagitis was 20% in concurrent group. Conclusions Low-dose .vinorelbine/cisplatin chemoradiotherapy was effective and tolerable for treatment of locally advanced NSCLC.