放化同步治疗中老年局部晚期非小细胞肺癌时紫杉醇剂量选择的研究

Dosage selection of paclitaxel in concurrent radio-chemotherapy for elderly locally advanced non-small cell lung cancer

目的探讨放化同步治疗中老年非小细胞肺癌（NSCLC）时紫杉醇剂量的选择。方法选择60例NSCLC患者,其中男性36例,女性24例;年龄55~65岁。随机分为A、B、C、D、E 5组,每组12例患者。所有患者先经过3个周期的诱导化学治疗,1个月后进行放化同步治疗。三维适形放射治疗在5~6周内完成,控制总剂量在60 Gy;化学治疗时使用紫杉醇,A组2次/周,每次10mg/m2;B组2次/周,每次15 mg/m2;C组2次/周,每次20 mg/m2;D组3次/周,每次10 mg/m2;E组3次/周,每次15 mg/m2,6周完成治疗。当任何一组患者在治疗期间出现半数以上的患者发生3度以上急性不良反应即停止该组试验。结果 A、B、D 3组出现3度以上不良反应的患者均未超过半数,完成所有治疗,近期总有效率分别为41.67%、75.00%、66.67%;C、E两组因出现3度以上不良反应的患者超过半数而停止试验。结论在诱导化疗后使用放化同步治疗中老年局部晚期NSCLC患者时紫杉醇最佳使用剂量的选择为每周30 mg/m2,可根据患者具体身体状况调整每次给药剂量和给药次数,并于5~6周完成治疗。

Objective To study the dosage selection of paclitaxel in the concurrent radio-chemotherapy for the elderly advanced of phase Ⅲa/Ⅲb non-small cell lung cancer.Methods A total of 60 patients with non-small cell lung cancer were enrolled,included 36 males and 24 females,who were 55-65 years old.All of them were randomly divided into 5 groups（group A,B,C,D and E,12 samples for each group）,and performed the inductive chemotherapy for 3 cycles,then received continual threedimensional conformal radiotherapy（60 Gy） within 5-6 weeks after one month.The paclitaxel was delivered concurrently for 6 weeks with the dosage of 10 mg/m2,15 mg/m2and 20 mg/m2twice a week for group A,B and C,respectively;And with the dosage of 10 mg/m2and 15 mg/m2for three times a week for group D and E,respectively.The experiments were stopped when more than half of patients in any group had 3-level acute adverse reactions during the treatment.Results Group A,B and D finished the whole treatment,the total efficiency was 41.67 %,75.00 % and 66.67 %,respectively.Because more than half patients had 3-level acute adverse reactions,group C and E stopped the treatment.Conclusion It is demonstrated that the most prominent dosage of paclitaxel in concurrent radio-chemotherapy for the elderly locally advanced non-small cell lung cancer is 30 mg/m2each week,dosage and frequency can be adjusted according to the condition of patients,the treatment could be completed within 5-6 weeks.