多西紫杉醇/顺铂化疗同步放疗对局部晚期非小细胞肺癌疗效观察

Concurrent chemoradiotherapy with docetaxel/cisplatin for local advanced non-small cell lung cancer

目的研究多西紫杉醇／顺铂化疗同步放疗对晚期非小细胞肺癌的疗效及毒副作用。方法76例Ⅲ期非小细胞肺癌患者被随机分为两组，多西紫杉醇，顺铂化疗同步放疗组（同步组），多西紫杉醇，顺铂化疗序贯放疗组（序贯组）；两组放疗方法相同，放疗剂量肌60～70Gy，每次2Gv，每周5次，化疗方案为多西紫杉醇40mg／m^2，第1、8天用药，顺铂20mg／d，第1、5天用药。21天为一周期。同步组化疗第1天即开始放疗，序贯组在化疗2周期后放疗。结杲同步组和序贯组的有效率分别为65．7％和41．5％（P〈0．05），两组的完全缓解率分别为17．1％和7．3％（P〉0．05），放射性肺炎及食管炎发生率同步组高于序贯组（P〈0．05）。结论放疗同步多西紫杉醇／顺铂化疗治疗晚期非小细胞肺癌疗效优于序贯化放疗方法，副反应虽增加，但可耐受。

Objective To evaluate the efficacy and side effects of concurrent radiotherapy and chemotherapy with docetaxel/cisplatin for local advanced non-small cell lung cancer （NSCLC）. Methods A total of 76 patients with stage m NSCLC were randomly divided into two groups： the docetaxel/cisplatin chemotherapy concmrent radiotherapy group（concurrent group） and the docetaxel/cisplatin chemotherapy sequential radiotherapy group（sequential group）. In the two groups, the radiation method was the same, five times a week at 2 Gy per day up to a total dose of 60-70 Gy. Chemotherapy consisted of docetaxe140 mg/m^2 dl, 8 and cisplatin 20 mg/d, on day 1 and 5, lasting 21 days. The concurrent group received radiotherapy on day 1 of chemotherapy, while the sequential group received radiotherapy after 2 chemotherapy cycles. Results The response rate in the concurrent group was 65.7% and 41.5% in sequential group （P 〈 0.05）. The complete response rate was 17.1% in the concurrent group and 7.3 % in sequential group （ P 〉 0.05）. The acute toxic effects such as radiation esophagitis were more severe in the concurrent group than in the sequential group （ P 〈 0.05）. Conclusion Concurrent radiotherapy and chemotherapy with docetaxel/cisplatin is an effective regimen for advanced non-small cell hmg cancer with increased but tolerable toxic effects.