三维适形大分割放疗联合TP方案治疗老年局部晚期非小细胞肺癌的临床观察

Three-dimensional conformal Hypofractionated Radiotherapy combined with TP Regimen for Treatment of Senile Locally Advanced Non-small Cell Lung Cancer

目的 观察三维适形大分割放疗联合TP 方案治疗老年局部晚期NSCLC 的临床疗效和毒副反应.方法 46 例NSCLC 患者采用三维适形大分割放疗,每次4 ～ 8Gy,3f/W,总剂量40 ～ 64Gy.放疗结束后1 ～ 2 周给予TP 方案化疗,具体为：多西他赛75mg/m2 静滴,d1;卡铂300mg/m2 静滴,d1,3 ～ 4 周为1 周期,共2 ～ 4 周期.化疗结束后1 个月评价疗效.结果 46 例患者均完成治疗,总有效率为89.1%,1、2、3 年生存率分别为82.6%、47.8% 和26.1%.急性放射性肺炎发生率为17.4%,急性放射性食管炎发生率8.7%,白细胞减少发生率为73.9%,恶心呕吐发生率为21.7%,均为1~2 级.结论 三维适形大分割放疗联合TP 方案治疗老年局部晚期NSCLC 患者的疗效可靠,毒副反应轻,值得临床进一步研究.

Objective To evaluate the clinical efficacy and toxicity of three-dimension conformal radiotherapy sequential TP regimen for treatment of elderly patients with locally advanced non-smaU cell lung cancer. Methods 46 case of elderly patients with locally advanced NSCLC were treated by three-dimension conformal hypofractionated high dose radiotherapy： total dose from 40 to 64Gy,6 to 8Gy for each fi＇action,3f/W. TP regimen （ docetaxel 75 mg/m2, dl and carboplatin 300 mg/m2, dl, 21-28 days was a cycle） followed 1-2 weeks after 3DCRT.Each patient should complete no less than two cycles＇ chemotherapy.The response and toxicity were evaluate and survival rats was followed up. Results The toal response rate was 89.1%.The 1-,2- and3- year survival rats was 82.6%,47.8%,and 26.1%.The main toxicities were local radiation pneumonia （17.4%） ,radiation esophagitis （8.7%） ,leucopenia （73.9%） ,and nausea/vomiting （21.7%） ,mainly grade 1-2. Conclusion The three dimensional conformal hypofractionated high dose radiotherapy sequential TP regimen for elderly patients with locally advanced NSCLC is effective. The toxicities are mild, It is worthy of further study.