局部晚期非小细胞肺癌三维适形放射治疗联合化疗的临床观察

Research on three dimensional conformal radiotherapy combined with taxol and cisplatin chemotherapy concurrently in treatment of limited advanced non-small cell lung cancer

目的探讨三维适形放疗(3DCRT)同步联合紫杉醇(TAX)+顺铂(DDP)之TP化疗方案治疗局部晚期非小细胞癌(NSCLC)的近期疗效。方法选取2010年1月至2012年5月间收治的局部晚期NSCLC患者88例,随机分为A组(46例)和B组(42例),B组患者采用3DCRT放疗治疗,A组患者在此基础上加TP化疗方案,观察并记录两组患者的近期疗效和药物不良反应。结果 A组患者完全缓解率为13.0%,总有效率为82.6%,KPS评分为(79.5±8.2)分,均高于B组患者的4.8%、64.3%和(75.7±7.8)分,两组患者总有效率和KPS评分差异有统计学意义(P<0.05)。A组患者骨髓抑制、放射性肺损伤和末梢神经损害发生率高于B组(P<0.05);同步放化疗期间病死率(4.3%,2/46)高于B组(2.4%,1/42),但差异无统计学意义(P>0.05)。结论 3DCRT放疗同步联合TP化疗方案能有效控制NSCLC原发病灶进展,提高患者生活质量,积极处理同步放化疗期间的不良反应尤为重要。

Objective To explore the clinical efficacy of 3DCRT radiotherapy combined with TP chemotherapy concurrently in treatment of patients with limited advanced NSCLC.Methods 88 admitted cases from Nov 2010 to May 2012 were randomly divided into group A（n = 46） and group B（n = 42）,group B was treated with 3DCRT radiotherapy scheme,and based on which group A was applied with TP chemotherapy scheme,clinical efficacy,toxic reactions and KPS score were noted and compared.Results ① Complete remission rate,total efficiency rate and KPS score of group A after treatment course were higher than those of group B,and the difference of total efficacy rate and KPS score were statistically significant.② Incidence rate of myelosuppression,peripheral nerve damage,radiation induced lung injury in group A during treatment was higher than that of group B（P 0.05）;besides,death rate（4.3%） of group A was also higher than that of group B（2.4%）,but there was no statistical difference（P 0.05）.Conclusions 3DCRT radiotherapy combined with TP chemotherapy scheme concurrently in treatment of limited advanced NSCLC obtain good efficacy in control of primary lesion.Actively dealing with toxicity reactions is particularly important during chemoradiation.