周剂量用紫杉醇同步三维适形放疗治疗老年局部晚期非小细胞肺癌的临床研究

A Clinincal Study of Weekly Dose of Paclitaxel and Concurrent 3-Dimensional Conformal Radiotherapy for Elderly Patients with Locally Advanced Non-Small-Cell Lung Cancer

目的评价周剂量用紫杉醇同步三维适形放疗治疗老年局部晚期非小细胞肺癌的疗效和毒副反应。方法57例随机分为两组,化放组在三维适形放疗同时行化疗,紫杉醇60 mg/m2,静脉滴注,1次/周,连用3周,休息1周,共使用6周;单纯放疗组:三维适形放疗。结果化放组:CR率12.2%,PR率44.8%,总有效率(CR+PR)为57.0%;单放组:CR率14.3%,PR率25.0%,总有效率为39.3%,两组比较差异有统计学意义(P<0.05)。化放组和单放组的1、2年生存率分别为65.5%、34.5%和53.5%、28.0%,中位生存时间分别为16个月和10.2个月,差异有统计学意义(P<0.01)。结论周剂量用紫杉醇联合三维适形放疗同步治疗老年局部晚期非小细胞肺癌安全有效,值得进一步临床研究。

Objective To evaluate the efficacy and toxicity of weekly dose of paclitaxel and concurrent 3-dimensional conformal radiotherapy for elderly patients with locally advanced non-small-cell lung cancer.Methods Fifty-seven patients were divided into the following groups： the group 1 was given to 3-dimensional conformal radiotherapy and concurrent chemotherapy with paclitaxel at a weekly dose of 60 mg/m2,iv,for 3 weeks as 1 course.The next course started after 1 week interval and the group 2 was given to a total 3-dimensional conformal radiotherapy.Results The overall response rate was 57.0% in the group 1 and was 39.3% in the group 2, respectively（P〈0.05）.The survival rate was 65.5% at 1 year,34.5% at 2 year in the group 1,and 53.5% at 1 year,28.0% at 2 year in the group 2,the median survival was 16 months in the group 1 and compared with 10.2 months in the group 2,respectively（P〈0.01）.Conclusion Paclitaxel and concurrent 3-dimensional conformal radiotherapy for elderly patients with locally advanced non-small cell-lung cancer is a well-tolerated regimen in acceptable toxicity and will be an optimal therapy.Schemes are required to improve disease control and overall survival.