局部晚期非小细胞肺癌维持化疗的疗效评价

Evaluation of the clinical efficacy of maintenance chemotherapy for local advanced non-small cell lung cancer

目的:本研究旨在评价初次放化疗有效的局部晚期非小细胞肺癌患者接受维持化疗的疗效。方法:120例ⅢA和ⅢB期非小细胞肺癌患者接受4个周期的诱导化疗联合放疗后,将其中治疗有效的63例患者随机分入维持化疗组(33例患者接受长春瑞滨维持化疗,20mg/m2第1和第8天,以28d为1个化疗周期)和对照组(30例患者只接受观察,不给予维持化疗),评估这两组患者的疗效、生存期和不良反应。结果:维持化疗组的中位疾病进展时间较对照组延长(分别为8.5和5.0个月),差异有统计学意义(P<0.05);维持化疗组的1年和2年生存率分别为66.7%和36.4%,对照组为60.7%和32.1%,差异均无统计学意义(P>0.05)。结论:诱导化疗有效的局部晚期非小细胞肺癌患者接受长春瑞滨维持化疗后,可延长疾病进展时间,但对生存期无影响。

Objective：To evaluate the clinical efficacy of maintenance chemotherapy for patients who had local advanced non-small cell lung cancer（NSCLC） and was responsive to primary radiotherapy and chemotherapy.Methods：One hundred and twenty patients with stage ⅢA or ⅢB NSCLC received 4 cycles of chemotherapy combined with radiotherapy.The 63 patients who achieved certain remission were randomly divided into maintenance chemotherapy group（n=33） and control group（n=30）.The patients in maintenance chemotherapy group（treatment group） received vinorelbine（20 mg/m2,d 1 and d 8,per 28 d a cycle） and those in control group were not given maintenance chemotherapy.The clinical efficacy,survival rate and adverse reaction of the two groups were evaluated.Results：There are a longer median time to progression（TTP） in treatment group compared with control group（8.5 month vs 5.0 month,P0.05）.The 1-and 2-year survival rates were 66.7% and 36.4% in the treatment group and 60.7% and 32.1% in the control group,respectively.The difference between the survival rates of two groups was not significant（P0.05）.Conclusion：Maintenance vinorelbine-based chemotherapy prolonged the median time to progression but had no effect on survival time in patients with local advanced NSCLC who responded to induction chemotherapy.