放疗联合长春瑞滨加顺铂同步治疗Ⅲ期非小细胞肺癌的临床研究

Concomitant radiochemotherapy using vinorelbine plus cisplatin for stageⅢnon-small cell lung cancer

目的为了比较放射治疗联合长春瑞滨(NVB)加顺铂(DDP)同步与序贯放化疗治疗Ⅲ期非小细胞肺癌(non-small cell lung cancer,NSCLC)的疗效及毒副反应。方法将64例Ⅲ期NSCLC患者随机分成2组,同步放化疗组(32例):放疗第1天起即同时开始化疗。序贯放化疗组(32例):入组后先予化疗2个疗程,再单独予放疗。结果近期有效率(CR+PR)同步放化疗组为68.7%,序贯放化疗组为43.7%,P=0.03。1、2、3年生存率同步放化疗组为75%、40%、21%。序贯放化疗组为50%、25%、12%。3年生存率差异有统计学意义,P=0.041。两组患者的毒副反应主要为可逆性骨髓抑制、放射性食管炎,两组发生率相似(χ2=1.65,P>0.05),患者大多能耐受。结论初步研究结果提示,放射治疗联合长春瑞滨(NVB)加顺铂(DDP)同步放化疗治疗Ⅲ期NSCLC的疗效优于序贯放化疗,不良反应可耐受,值得进一步研究。

Objective The objective of this study was to compare the effect and the clinical toxicity of concurrent and sequential chemoradiotherapy（CRT） with vinorelbine and cisplatin in stage Ⅲ non-small cell lung cancer（NSCLC） patients. Methods Sixty-four patients with stage Ⅲ NSCLC were randomly assigned into two groups. Concurrent CRT group （ 32 cases） ： When radiotherapy （RT） was the started, chemotherapy （CT）was started on the frist day. Sequential CRT group（32cases） ：Acceptted 2 cycles CT before RT, when RT was finished, then accepted 2-4 cycles CT. Results The overall response rate（ CR ＋ PR）was significantly higher in the concurrent CRT group 68. 7% compared with the sequential CRT group 43.7% ,P =0. 03. The 1-year,2-year and 3-year survival rates were 75% ,40% ,21% in the concurrent CRT group, and 50% ,25 %, 12% in the sequential CTR group. The toxic effectssuch as White blood cell decline and esophagitis can be tolerable. Conclusion In this study population, concurrent CRT with vinorelbine and cisplatin in stage Ⅲ NSCLC demonstrated significant benefit in terms of response rate. The toxicity was tolerable. It is valuable to investigate more deeply.