同步放化疗治疗中晚期非小细胞肺癌临床分析

The Clincial Analysis of Concurrent Chemo-Rediotherapy for Middle and Advanced Stage Non-Small Cell Lung Cancer

目的观察同步放化疗治疗中晚期非小细胞肺癌（NSCLC）的疗效和毒副反应。方法入组不能手术的中晚期NSCLC 63例,随机分为两组。序贯组33例,化疗2周期后再行放疗;同步组30例,放化疗同时进行。化疗采用紫杉醇加顺铂方案,放疗剂量66.0-70.0 Gy。结果序贯组和同步组的总有效率分别为42.4%、70.0%,差异有统计学意义（P〈0.05）;序贯组与同步组的1、2、3年生存率以及中位生存时间分别为42.4%、23.1%、6.6%、11.0月和60.0%、35.1%、30.1%、18.0月,差异均有统计学意义（P〈0.05）;同步治疗的毒副反应多于序贯治疗,但两组均无Ⅳ级毒副反应发生。结论同步放化疗治疗NSCLC的疗效优于序贯治疗;其毒副反应虽有所增加,但均可耐受。

Objective To evaluate the clinical effect and toxicities of concurrent chemo-rediotherapy middle and advanced stage non-small cell lung cancer（NSCLC）.Methods Sixty three patients with middle and advanced stage NSCLC were randomized into two groups.33 patients of the sequential group received two cycles of chemotherapy and then underwent radiotherapy.30 patients of the synchronous group accepted radiotherapy and chemotherapy at the same time.The regimen of chemotherapy include paclitaxel plus cisplatin.All the patients received the radiotherapy with a dose of 66.0-70.0 Gy.Results The overall response rate was 42.4% in the sequential group and was 70.0% in the synchronous group,there was the significant difference（P〈0.05）.The 1-,2-and 3-year overall survival rates of the sequential group were 42.4%,23.1% and 6.6%,respectively;and the median survival time was 11.0 months.The 1-,2-and 3-year overall survival rates of the synchronous group were 60.0%,35.1% and 30.1%,respectively;and the median survival time was 18.0 months.There was significant difference（P〈0.05）.Synchronization treatment had more toxicities than sequential treatment,but the two groups had no Ⅳ stage toxicities.Conclusion The clinical effect of concurrent chemo-rediotherapy for NSCLC is superior to that of sequential treatment;the toxicities also increased,and they are tolerable.