维甲酸在肺癌放疗中应用的近期临床观察

The short term clinical observation of application of Retionic acid in radotherapy for aderocaroinoma of lung

目的本文报道分析了维甲酸联合放射治疗与单纯放射治疗，对中晚期肺腺癌的疗效及放射治疗期间的毒副反应。方法从１９９４年１月至１９９５年１月收治中晚期肺腺癌２０例，１０例维甲酸加放疗，１０例单纯放射治疗，两组均用直线加速器，常规分割放射治疗，肿瘤量６０～７０Ｇｙ／６～７周，维甲酸加放疗组，放疗前１０～２０分钟口服维甲酸３０～６０ｍｇ／ｍ２。从放疗开始连服４６天为１周期，放疗结束后休息７～１４天重复１个周期。结果维甲酸加放疗组：ＣＲ６０％，ＰＲ２０％，Ｓ２０％；单纯放疗组：ＣＲ４０％，ＰＲ４０％，Ｓ２０％。在治疗过程中观察血象，肝、肾功能、胃肠道反应两组均未发现明显毒反映。结论结果显示放疗加维甲酸治疗中晚期肺腺癌疗效优于单纯放射治疗，其机理在于维甲酸使Ｇ１期延滞和Ｇ２～Ｓ期转换受到抑制，使癌细胞阻断于对放射线敏感的Ｇ１期增加放疗效果。

Objective To analyze the effect of Retionic acid combined with radiotherapy and radiotherapy alone for adenocarcinoma of lung,and to observe the toxicities of radiotherapy.Methods From January 1994 to January 1995 20 patients with advanced adenocarcinoma of lung were randomly divided into two group, 10 patients were treated by retionic acid combined with radiotherapy (PA～RT groop),10 patients by radiotherapy alone (RT groop);All patients received DT 60～70 Gy/6～7/w with accelerator,2Gy/F/D.The patients in PA～RT group oraly retionic acid 30～60mg/m 2 at 10～20 minutes before radiotherapy,the same dose of retionic acid was used till 46th day,and repeated at 7～14th day after irradiation.Results The complete response,patial response and no change rate in PA～RT group and in RT group was 60%,20%,20%;40%,40%,20%,respectively.No toxicities were observed in two group.Conclusion The effect of retionic acid combined with radiotherapy for advanced adenocarcinoma of lung is superior to radiothrapy alone.The mechanism is that retionio aoid can make the cacinous cells in cellcycle stop at G1 Phase,which were more radiosensitive and easily killed by irradiation.