TP方案化疗并分段加速超分割放射治疗局部晚期非小细胞肺癌效果

EFFECT OF TP CHEMOTHERAPY COMBINED WITH SUBSECTION ACCELERATED SPLIT-COURSE RADIOTHERAPY FOR LATE-STAGE LOCALIZED NON-SMALL CELL LUNG CANCER

目的观察顺铂（DDP）和多西他赛（DOC）化疗联合分段加速超分割放射治疗局部晚期非小细胞肺癌的效果。方法对52例局部晚期非小细胞肺癌病人采用DDP和DOC方案联合分段加速超分割放疗，DDP30mg／m^2，静脉滴入，第1～3天；DOC75mg／m^2，静脉滴入，第1天；以28d为1周期。第4天开始行分段加速超分割放疗，每次1．5Gy，每日2次，每周15Gy，共45Gy。第2周期化疗后改行常规放疗，每日1次，每次2Gy，共10Gy，使肿瘤放疗总量达55Gy。后重复TP方案化疗2周期。结果完全缓解10例，部分缓解26例，总有效率为69．2％。1年生存率65．2％，2年生存率53．1％，中位生存时间18个月。毒性反应主要为白细胞减少，恶心呕吐和脱发。结论TP方案化疗联合分段超分割放射治疗局部晚期非小细胞肺癌缓解率高，毒性反应可以耐受。

Objective To evaluate the efficacy of platinum （DDP） and doxetaxole （DOC） combined with phase accelerated hyperfraction radiotherapy for locally advanced non-small cell lung cancer. Methods Fifty two patients with this cancer were given chemotherapy as follow： DDP 30 mg/me, day 1 3, intravenously; and DOC 75 mg/m^2, day 1, intravenously, 28 days per cycle. 15 Gy of radiotherapy was given on day 4-8, 1, 5 Gy/fraction twice per day, 15 Gy/week, totalling 45 Gy. After the second cycle of chemotherapy, a conventional radiation was carried out, 2 Gy for each therapy, 10 Gy in total, making total amount of tumor to reach 55 Gy. TP chemotherapy was then repeated for two weeks. Results Complete remission （CR） 10 cases, partial remission （PR） 26 cases, total response rate （CR＋PR） 69.2%. The median survival time was 18 months. One-year survival was 65.2%, two-year survival, 53.1%. The major toxicities were neutropenia, nausea, vomiting and alopecia. Conclusion Chemotherapy of TP regimen combined with phased accelerated hyperfraction radiotherapy for locally advanced non-small cell lung cancer possess high response rate, the toxicities are tolerable.