联合化疗与分段加速超分割放疗治疗晚期非小细胞肺癌

COMBINATION OF GP REGIMEN AND SPLIT-COURSE HYPERFRACTIONATED ACCELERATED IRRADIATION IN ADVANCED NON-SMALL CELL LUNG CANCER

目的观察GP联合化疗与分段加速超分割放疗治疗局部晚期非小细胞肺癌的疗效。方法所选病人进行3个周期共12周的GP联合化疗和分段加速超分割放疗。联合化疗方案为在1～3天进行顺铂静脉滴注,第1、8天进行吉西他滨静脉滴注,二者浓度分别为30mg/m2和1000mg/m2,在4～8天进行分段加速超分割放疗,1.5Gy/次,2次/天,两次间隔最好6小时以上,共15Gy/周期,治疗达第3周期后,在第11～15天加常规放疗,2Gy/次,1次/天,使放疗的总剂量达到55Gy。3周期治疗后,再应用MVP方案化疗2个周期,4周为1个周期。结果 60例患者中,19例达CR,28例PR,有效率为81.6%。1年生存率为67.6%,2年生存率为59.1%。结论 GP化疗方案与分段加速超分割放疗联合治疗局部晚期非小细胞肺癌的疗效显著,生存期较长,毒副作用相对较小。

Objective To investigate the efficacy of GP regimen combined with split -course hyperfraetionated accelerated irradiation for advanced non - small cell lung cancer. Methods The treatment to patients was composed of 3 cycles of combined chemoradiotherapy at 4 -week intervals. Chemotherapy with cisplatin （30 mg/m^2） was administrated intravenously on days 1 - 3, and gemcitabine （1 000 mg/m^2 ） was on the first and eighth day, followed by radiotherapy on days 4 -8. A coarse of radiotherapy consisted of 1.5 Gy per fraction, twice a day （3 Gy per day） with a interval more than 6 h, for a total dose of 15 Gy. After the third cycle, additional irradiotherapy consisted of 2 Gy once a day was performed on days 11 - 15, for a total dose up to 55 Gy during 10 weeks. After three cycles, patients were given 2 additional cycles of chemotherapy with MVP regimen. Results Of the 60 patients, 19 had a complete remission and 28 a partial response, resulting in an overall response rate of 81.6%. The 1 - and 2 - year survival rates were 67.6% and 59.1%, respectively. Conclusion GP regimen combined with split - course hyperfractionated accelerated irradiation is effective and well tolerated for advanced non - small ceil lung cancer.