分段周量紫杉醇同步三维适形放疗治疗老年非小细胞肺癌

The Effect of Conformal Radiotherapy Combined with Weekly Paclitaxel in the Treatment of Elderly Patients with Non-small Cell Lung Cancer

目的探讨分段周量紫杉醇同步三维适形放射治疗老年非小细胞肺癌的临床疗效。方法对经细胞学或病理检查证实的45例老年非小细胞肺癌患者,采用放疗联合紫杉醇同步化疗。放疗采用三维适形放疗技术累及野照射,总照射剂量为60～72 Gy,中位剂量为66 Gy。同步应用紫杉醇60 mg/次,静脉滴注,第1、8、15天及第36、435、0天。结果近期疗效总有效率(CR+PR)为82.2%,不良反应以骨髓抑制及食管反应为主,但经处理后均能顺利完成治疗;中位生存期21个月,1、2年生存率分别为68.8%、48.8%。结论分段周剂量紫杉醇联合三维适形放疗治疗老年非小细胞肺癌疗效较好,不良反应能耐受,特别适合老年患者,值得临床进一步研究及应用。

Objective To investigate the clinical effects of conformal radiotherapy combined with weekly paclitaxel in the treatment of elderly patients with inoperable non-small cell lung cancer.Methods A total of 45 elderly patients with non-small cell lung cancer were treated with conformal radiotherapy combined with concurrent chemotherapy.The total doses of radiotherapy were 60~72 Gy（median dose,66 Gy）,and weekly dose of paclitaxel（60 mg,once per week） were given intravenously on day 1,8,15 and repeated in day 36,43,50.Results The overall response rate（CR＋RR） were 82.2%,The main toxicities included bone marrow suppression and esophageal reactions.All toxicities were tolerable and all patients completed the treatment.Median survival time（MST） was 21 mouths,and the 1 and 2 year overall survival rate were 68.8% and 48.8%,respectively.Conclusion Weekly paclitaxel and conformal radiotherapy is effective in the treatment of elderly patients with non-small cell lung cancer.The side effects are tolerable.This treatment modality needs further consideration.