EP方案化疗联合放疗治疗局限期小细胞肺癌疗效分析

Chemotherapy of EP strategy combined with radiotherapy in the treatment of limited - stage small - cell lung cancer

目的探讨化疗联合放疗治疗局限期小细胞肺癌（SCLC）的疗效。方法将89例符合条件的局限期SCLC患者随机分为化放交替组和化放序贯组。所有患者均行EP方案化疗：顺铂40mg／d，第1～3天静脉滴注；依托泊昔100mg／d，第1—5天静脉滴注，3周为1个周期，共化疗4～6个周期。放疗常规分割，DT56～60Cy。结果交替组与序贯组完全缓解（CR）率、部分缓解率、有效率分别为38％、51％、89％和23％、61％、84％（P〉0．05）；局部复发率和远处转移率分别为18％、23％和21％、30％（P〉0．05），1、2、3年生存率两组分别为71％、38％、17％和67％、31％、15％（P〉0．05）。两组Ⅱ＋Ⅲa病例的CR率、2年生存率分别为65％和33％、52％和39％（P〈0．05）。结论化疗联合放疗治疗局限期SCLC近期效果满意，化放交替组和化放序贯组疗效差异无统计学意义，但TNM分期可能为影响预后的因子。

Objective To evaluate of chemotherapy combined with radiotherapy in the treatment of limited- stage small- cell lung cancer（ LD -SCLC ）. Methods Eightynine patients with LD - SCLC were randmized into interdigitating chemoradiotherapy group and sequential chemoradiotherapy group. All patients received four to six cycles of alternating EP（ P： cisplatin 40 mg d1-3 ,E ：etoposide 100 mg d1-5 ）chemotherapy, three weeks for a cycle, All patients also received thoracic radiotherapy with conventional fraction ,2.0 Gy per fraction, five fractions per week. The total dose was 56 - 60 Gy. Results Interdigitating chemoradiotherapy group and sequential chemoradiotherapy group, CR were 38% and 23%, PR were 51% and 61% , CR ＋ PR were 89% and 84%. Its frequenciesof local recurrence and distant metastasis were 18% ,23% and 21% ,30% （P 〉 0.05）. The 1 - ,2 - ,3 -year survial rates were 71% ,38% ,17% and 67% ,31% ,15% （P 〉 0.05）. The II ＋ Ⅲa patients of interdigitating che- moradiotherapy group and sequential ehemoradiotherapy group, CR was 65% and 33% , The 2 - year survial rates were 52% and 39% （P 〈 0.05）. Conclusions The therapeutic effect of chemotherapy combined with radiotherapy for LD - SCLC was satisfing. There was no significant difference in the effect between the two groups, but TNM stage may be still a signifieante prognostic factor.