三维适形放疗联合每周多西紫杉醇治疗局部晚期非小细胞肺癌

Clinical Study of Three-dimensional Conformal Radiotherapy Combined Docetaxol Weekly in Patients with Locally Advanced Non-small Cell Lung Cancer

【目的】研究三维适形放射治疗联合每周多西紫杉醇同期化疗治疗局部晚期非小细胞肺癌疗效和毒副作用。【方法】64例局部晚期非小细胞肺癌患者随机分成A组和B组进行临床研究,A组30例采用三维适形放射治疗,总剂量66～70Gy/33～35次,6～7周完成。B组34例采用三维适形放射治疗联合每周多西紫杉醇同期化疗。【结果】两组患者的总有效率分别为60.0%和79.4%,其中完全缓解率率分别为6.7%和29.4%,P<0.05,差异有显著性。两组1、2年生存率分别66.7%VS76.5%和40.0%VS52.9%,(P>0.05)。A组患者中位生存期为10.8个月,B组患者中位生存期为19.6个月。两组患者早期放射反应主要为Ⅰ～Ⅱ级放射性食道炎和骨髓抑制,后期放射反应主要为Ⅰ～Ⅱ级放射性肺炎,发生率两组接近。【结论】三维适形放射治疗联合每周多西紫杉醇同期化疗治疗局部晚期非小细胞肺癌疗效优于单纯三维适形放射治疗。

[Objective] To evaluate the therapeutic efficacy and the radiation complication of three-dimensional conformal radiotherapy（3DCRT） combined Docetaxol weekly in the patients with locally advanced non-small cell lung cancer （NSCLC）. [ Methods ] 64 patients with locally advanced NSCLC were randomly divided into two groups. The 30 patients in groups A received 3DCRT at the total dose of 66 to 70 Gy in 33 to 35 fractions completed in 6 to 7 weeks. The 34 patents in group B received 3DCRT combined Docetaxol weekly. [Results] The efficacy rates in group A and B were 60.0% and 79.4%, and the complete remission rates were 6.7% and 29.4%, respectively, with statistical outstanding （P 〈 0.05）. The 1 and 2 year survival rates of the patients in group A and B were 66.7% VS 76.5%, 40.0% VS 52.9% respectively, without significant difference （P 〉 0.05）. The median survival time in group A and B were 10.8 months and 19.6 months, respectively. The major radiation complication observed in the two groups were grade I to II acute radiation esophagitis and hematopoietie toxicity. The later radiation complication in the two groups were grade I to II radiation lung fibrosis, without significant difference. [ Conclusion ] The efficacy of 3DCRT combined Docetaxol weekly is better than 3DCRT in the patients with locally advanced NSCLC.