EP与TP方案同步化放疗治疗Ⅲ期非小细胞肺癌疗效观察

Study of Concurrent Chemoradiation with EP and TP Regimens in Stage Ⅲ Non-small-cell Lung Cancer

目的观察EP与TP方案同步化放疗治疗Ⅲ期非小细胞肺癌的疗效。方法86例Ⅲ期非小细胞肺癌患者随机分为TP组42例和EP组44例,EP组采用EP方案化疗4个周期,TP组采用TP方案化疗4个周期,并于第1周期化疗第1天开始放疗。两组放射治疗均采用6MVX直线加速器常规分割治疗,放射治疗总量DT60～70Gy,6～7周完成。结果EP组CR8例,PR30例,有效率(CR+PR)86.4%;TP组CR8例,PR29例,有效率(CR+PR)88.1%,两组有效率差异无统计学意义(P>0.05)。EP组1、2、3年生存率分别为65.9%、45.5%、29.5%;TP组和EP组中位生存期分别为19.2个月和l8.5个月。2组间中位生存期及1、2、3年生存率差异无统计学意义(P>0.05)。两组的恶心、呕吐、骨髓抑制、放射性食管炎和放射性肺炎发生差异无统计学意义(P>0.05)。结论EP与TP方案同步化放疗均能对Ⅲ期NSCLC起到很好的疗效,TP组在近期有效率、中位生存期及2、3年生存期上均较EP组高;而EP组的不良反应发生率较低,患者的生活质量和治疗依从性相对较好。

Objective To evaluate the effects of concurrent chemoradiotherapy with EP and TP Regimens in stage Ⅲ non-small-cell lung cancer（NSCLC）.Methods From February 2002 to October 2006,86 patients with stage Ⅲ NSCLC were randomized into two groups：TP group（42 patients） received radiotherapy plus concurrent chemotherapy with Paclitaxel（150mg/m^2,d1） and DDP（25mg/m^2,d1-d3） per cycle for 4 cycles.EP group（44 patients） received radiotherapy plus concurrent chemotherapy with DDP（25mg/m^2,d1-d3） and Vp-16（100 mg/m^2,d1-d3） per cycle for 4 cycles.In both groups,radiation was given to a total dose of 60-70Gy/6-7 weeks.Results The overall response rate（CR＋PR） in EP group was 86.4% with a complete response（CR） rate of 18.2%.The overall response rate in TP group was 88.1% with a CR rate of 19.1%.The median survival periods were 19.2 months in TP group and 18.5 months in EP group（P0.05）.The l-,2-and 3-year survival rates were 64.3%,47.6%,33.3%,and 65.9%,45.5%,29.5% in TP and EP groups,and the difference in the survival rates was no significant（P0.05）.Conclusion There is no significant survival advantage for cisplatin-paclitaxel compared with cisplatin-etoposide.Concurrent chemoradiation with EP and TP regimens in stage Ⅲ non-small-cell lung cancer patients is acceptable.