放、化疗序贯与同步治疗中晚期非小细胞肺癌疗效分析

Treatment Results Analysis of Sequential and Concurrent Chemoradiotherapy for Middle and Advanced Stage Non-small Cell lung Cancer

目的比较放、化疗序贯与同步治疗中晚期非小细胞肺癌(NSCLC)的临床疗效。方法选择NSCLC患者100例随机进行放、化疗同步治疗组和化、放疗序贯治疗组。同步组于放疗开始的1周、4周、8周、12周给予化疗,序贯组在4个周期的化疗结束后给予放射治疗,2组病例均给予常规放疗。结果同步组和序贯组的近期疗效有效率分别为82%和64%;1 a、3 a、5 a生存率、中位生存期分别为76%、32%、15.7%(28个月)和62%、22%、9.9%(18.6个月),两组差异有显著性(2χ=4.373,P<0.05)。两组患者的毒副反应主要为可逆性骨髓抑制、放射性食管炎和放射性肺炎,两组发生率相似。结论放、化疗同步治疗MSCLC效果好于化、放疗的序贯治疗。

Objective To evaluate the clinical effects of sequential and concurrent therapy for middle and advanced stage non-small cell lung carcinoma（NSCLC）. Methods One hundred patients with non-small cell lung cancer were randomized into two groups：concurrent radiochemotherapy group （group C）and sequential radiochemotherapy group（group S）. All patients in the two groups were treated with conventional radiotherapy. Patients in group C received concurrent chemotherapy in the first, fourth, eighth, twelfth week. Patients in group S received four cycles of sequential chemotherapy before radiotherapy. Results The response rate was 82% in group C and 64% in group S. The 1-, 3-, 5-year survival rates and median survival time were 76% , 32% , 15.7% and 28 months in group C ,while 62% , 22% , 9.9% and 18.6 months in group S respectively, with significant difference. The toxicity in the two groups had no significant differece. Conclusion The concurrent chemo-mdiotherapy has better overall response than the sequential chemo-radiotherapy. So it is a better method for the treatment of middle and advanced stage non-small cell lung cancer.