顺铂和每周多西紫杉醇联合三维适形放疗治疗Ⅲ期非小细胞肺癌31例

Cisplatin and weekly docetaxel with concurrent three dimensional conformal radiotherapy for locally advanced stage Ⅲ non-small cell lung cancer

目的探讨顺铂和每周紫杉醇化疗联合同步三维适形放疗治疗局部晚期Ⅲ期非小细胞肺癌(NSCLC)的疗效和安全性。方法对31例Ⅲ期NSCLC患者给予2个周期的化疗,多西紫杉醇20mg/m2,第1、8、15天静脉输注;顺铂75mg/m2,第1天静脉输注,28天为1个周期。在化疗开始第2天,给予同步三维适形放疗,总剂量60Gy,每次剂量2Gy,共治疗6周。结果 31例患者中,完全缓解2例,部分缓解17例,总有效率为61.3%。中位无进展生存时间为15.6个月(95%CI为11.6～19.6个月),1年生存率为74.2%。治疗中出现的主要3～4级毒副反应为中性粒细胞减少6例(19.3%),放射性食管炎4例(12.9%),放射性肺炎3例(9.7%)。结论顺铂和每周紫杉醇化疗联合同步三维适形放疗治疗Ⅲ期NSCLC疗效确切,毒副反应可以耐受。

Objective To evaluate the efficacy and safety of concurrent three dimensional conformal radiotherapy（3DCRT）and chemotherapy with cisplatin and weekly divided-dose docetaxel in patients with stage Ⅲ non-small-cell lung cancer（NSCLC）.Methods A total of 31 patients with locally advanced stage Ⅲ NSCLC had been enrolled.The patients received intravenous infusions of cisplatin（75 mg/m2,day 1）and docetaxel（20 mg/m2;day 1,8,15）,followed by a week＇s drug-free interval.Concurrent thoracic 3DCRT was given six weeks（2 Gy per fraction;total dose,60 Gy）.Results The overall response rate was 61.3% with complete and partial responses of two and 17 cases,respectively.The median PFS of all patients was 15.6 months（95% confidential interval CI,11.6~19.6）and 1-year survival rate was 74.2%.Over grade 3 neutropenia,esophagitis and pulmonary toxicityes were observed in 19.3%,12.9%,and 9.7% of patients,respectively.Conclusion Cisplatin and weekly docetaxel combined with concurrent 3DCRT is an effective and well-tolerated regimen for locally advanced NSCLC.