吉西他滨联合奥沙利铂序贯放疗治疗体力状况评分为2分的局部晚期非小细胞肺癌的疗效研究

Sequential Chemoradiation of Gemcitabine with Oxaliplatin for Locally Advanced Non-small Cell Lung Cancer

目的探讨吉西他滨联合奥沙利铂(Gemox方案)序贯放疗(RT)治疗局部晚期非小细胞肺癌的近期疗效和毒副作用。方法 66例局部晚期体力状况评分为2分的非小细胞肺癌患者随机分为两组,其中Gemox方案序贯放疗组(Gemox+RT组)34例,吉西他滨联合顺铂(GP方案)序贯放疗组(GP+RT组)32例,分别给予Gemox方案及GP方案化疗2周期后接受总剂量(DT)60-66 Gy放射治疗,放疗后再给予4个周期化疗。结果两组患者治疗后近期疗效比较,差异无统计学意义(P>0.05)。Gemox+RT组、GP+RT组的一年生存率分别为50.5%、61.2%,中位生存期分别为13、14个月,差异无统计学意义(P>0.05)。毒副反应:Gemox+RT组患者放射性肺炎的发生率为5.9%(2/34),≥III度放射性食管炎发生率为8.8%(3/34),与GP+RT组比较,差异无统计学意义(P>0.05);白细胞减少发生率为32.3%(11/34),血小板减少发生率为20.6%(7/34),均比GP+RT组低,差异均有统计学意义(P<0.05)。结论 Gemox方案序贯放化疗在局部晚期非小细胞肺癌较GP方案的耐受性高,且疗效相似,可以作为局部晚期非小细胞肺癌有效治疗方法。

Objective To evaluate the short-term curative effect of Gemcitabine plus oxaliplatin（Gemox protocol） radiotherapy（RT） on advanced non-small cell lung cancer（NSCLC） and its toxic and side effects.Methods Sixty-six NSCLC patients（physical score=2） were divided randomly into groups Gemox＋RT（n=34） and GP（gemcitabine plus cisplatin protocol） ＋RT（n=32）.Patients received a total dose（TD） of 60-66 Gy RT after 2 cycles of chemotherapy,and 4 cycles after radiotherapy.Results No significant difference was noted in short-term effect between 2 groups（P0.05）.The 1-year survival rates of groups Gemox＋RT and GP＋RT were 50.5%,61.2%,respectively,and median survival time was 13-14 months,the difference was not significant（P0.05）.The incidences of radiation pneumonia（5.9%） and radiation esophagitis ≥III（8.8%） of Gemox＋RT group were not significantly different from those of GP＋RT group（P0.05）.Incidences of leukocyte reduction and thrombocytopenia were lower in Gemox＋RT group（32.3%,20.6%,respectively） than in GP＋RT group（P0.05）.Conclusion Gemox sequential chemo-and radio-therapy,having higher tolerance than GP protocol and similar efficacy,is an effective treatment for NSCLC.