GP方案序贯三维适形放疗治疗老年局部晚期非小细胞肺癌疗效观察

Clinical observation of GP chemotherapy sequential 3D-CRT for elderly locally advanced non small cell lung cancer

目的:观察GP方案化疗序贯三维适形放疗(3D-CRT)治疗Ⅲ期老年非小细胞肺癌(NSCLC)的疗效及毒副作用。方法:回顾性分析我科2004年1月-2007年2月收治的62例Ⅲ期老年非小细胞肺癌(NSCLC),分成序贯放化疗组及单纯放疗组患者,序贯放化疗组32例,单纯放疗组30例。序贯放化疗组应用吉西他滨1000mg/m2,d1、8,顺铂30mg/m2,d2-4,常规止吐对症处理,21天为1个周期,接受3个周期化疗,化疗结束后3周行全程X线三维适形放疗DT66-70Gy/7周,2Gy/次,5次/周;单纯放疗组放疗方法同序贯放化疗组放疗,治疗完成4周后评价疗效和不良反应。结果:62例均完成治疗,单纯放疗组总有效率(CR+PR)为66.7%,完全缓解率(CR)为10%。单纯放疗组1、3、5年生存率分别为46.7%、13.3%、6.7%。序贯放化疗组总有效率(CR+PR)为81.3%,完全缓解率(CR)为12.5%;序贯放化疗组1、3、5年生存率分别为71.9%、37.5%、12.5%。两组总有效率差异有统计学意义(P<0.05),两组1、3年生存率差异有统计学意义(P<0.05)。放化疗的毒副反应主要是放射性肺损伤和放射性食管炎,但皆可耐受。结论:GP方案化疗序贯三维适形放疗治疗Ⅲ期老年非小细胞肺癌(NSCLC)可明显提高近期疗效和远期疗效,未增加明显不良作用。

Objective：To observe the clinical efficacy and toxicity of gemcitabine combined with cisplatin（GP regimen） sequential 3D-CRT for elder patients with locally advanced non-small cell lung canner（NSNLC）.Methods：From 2004 to 2007,62 elder patients with locally advanced non-small cell lung canner（NSNLC） were included,32 patients with locally elderly advanced NSNLC were treated by GP（gemcitabine 1000mg/m2 d1,d8,cisplatin 30mg/m2 d2-d4）.Each patient should complete no less than three cycle＇s chemotherapy.30 paeients were treated with 3D CRT alone.Total dose of GTV was DT66-70Gy /7weeks with 2Gy per fration.Results：The total response rate of sequential group was 81.3%.The 1-,3-,and 5-year survival rates were 71.9%,37.5%,12.5%.The total response rate of alone group was 66.7%.The 1-,3-,and 5-year survival rates were 46.7%,13.3%,6.7%.The total response rate of two group was ststistal significant（P 0.05） and the 1-,3-year survival rates of two groups was ststistal significant（P 0.05）.The major toxicities were local radiation pneumonia and radiation esophagitis.Conclusion：Gemcitabine combined with cisplatin（GP regimen） sequential 3D-CRT for treatment of elder patients with locally advanced non-small cell lung canner（NSNLC） is effective.The toxicies are mild.