立体定向放射治疗联合化疗治疗放疗后局部复发非小细胞肺癌的疗效

Efficacy of stereotactic radiotherapy combined with chemotherapy for local recurrent non-small-cell lung cancer after radiotherapy

目的:探讨立体定向放射治疗技术结合GP化疗方案(吉西他滨+顺铂)治疗首次放疗后局部复发的非小细胞肺癌患者的疗效。方法:38例首次放疗后局部复发的非小细胞肺癌患者接受立体定向放射治疗,处方剂量为3.00～4.85 Gy/次,每周5次,共8～12次,总疗程2～3周;放疗前基于GP方案化疗2个周期,放疗后再给予GP方案化疗4个周期。结果:38例患者的近期疗效为完全缓解7例、部分缓解23例,总有效率达到78.95%,6个月的总生存率为71.05%,1年的总生存率为10.53%,中位生存时间为7.8个月。结论:立体定向放射治疗首次放疗后局部复发的非小细胞肺癌显示出良好的近期疗效,患者能够耐受,未见严重的近期放射性损伤。晚期放射性损伤和远期疗效还有待进一步研究。

Objective：To study the efficacy of stereotactic radiotherapy（SRT） combined with gemcitabine plus cisplatin（GP）-based chemotherapy on local recurrent non-small-cell lung cancer（NSCLC） after radiotherapy.Methods：Thirty-eight patients with local recurrent NSCLC were treated with SRT（3.00-4.85 Gy per fraction,five times every week,totally 8-12 fractions,total course of 2-3 weeks）.Before SRT the patients were given two cycles of GP-based chemotherapy（gemcitabine 1 000 mg/m2 d 1 and d 8;cisplatin 30 mg/m2 d 1-3） and at the end of SRT they were given 4 cycles of GP-based chemotherapy.Results：Of the 38 patients,7 patients had complete response,and 23 patients achieved partial response.The overall immediate response rate was 78.95%（30/38）.The 6-month and 12-month total survival rates were 71.05% and 10.53%,respectively.The median survival time was 7.8 months.Conclusion：SRT combined with GP-based chemotherapy had better short-term efficacy and the patients were tolerable.No severe short-term radiation-induced injury was observed.The long-term radiation-induced injury and long-term efficacy need further investigation.