三维适形放射治疗联合吉西他滨或长春瑞滨治疗晚期非小细胞肺癌的疗效观察

Efficacy of three-dimensional conformal radiation therapy combined with vinorelbine or gemcitabine in treatment of advanced non-small cell lung cancer

目的探讨三维适形放射治疗联合长春瑞滨或吉西他滨治疗晚期非小细胞肺癌的近期疗效及不良反应。方法 164例Ⅲ～Ⅳ期不能手术切除的非小细胞肺癌(NSCLC)患者随机分为两组,先行诱导化疗后以三维适形放射治疗与化疗同步治疗,其中A组83例患者以长春瑞滨+顺铂为化疗方案,B组81例患者以吉西他滨+顺铂为化疗方案;分别统计两组患者完全缓解(CR)、部分缓解(PR)、稳定(SD)和进展(PD)例数及不良反应发生情况。结果 A组患者总有效率(CR+PR)为47.0%,疾病控制率(CR+PR+SD)为74.1%,1年生存率为54.2%,疾病进展时间为4.8个月,Ⅲ～Ⅳ度不良反应发生率为30.1%。B组患者总有效率为38.3%,疾病控制率为67.7%,1年生存率为40.4%,疾病进展时间为5个月,Ⅲ～Ⅳ度不良反应发生率为29.6%。两组比较,A组总有效率、疾病控制率和1年生存率均高于B组(均P<0.05);疾病进展时间和重度不良反应发生率两组间差异无统计学意义(P>0.05)。结论三维适形放射治疗联合长春瑞滨治疗晚期非小细胞肺癌近期疗效较好,不良反应均能耐受。

Objective To investigate the efficacy and adverse reactions of vinorelbine or gemcitabine combined with radiotherapy in the treatment of advanced non-small cell lung cancer.Methods 164 patients with stage Ⅲ~ Ⅳ unresectable non-small cell lung cancer（NSCLC） patients were randomly divided into two groups,the first induction chemotherapy followed by a three-dimensional conformal radiotherapy and chemotherapy concurrent treatment,including 83 cases of group A ＂vinorelbine Bin ＋ cis-platinum,＂as the chemotherapy group B 81 cases＂ gemcitabine ＋ cis-platinum ＂for chemotherapy;respectively statistics two groups of patients completely remission（CR）,partial remission（PR）,stable（SD） and progress（PD） the number of cases and the incidence of adverse reactions.Results A group response rate（CR ＋ PR） was 47.0%,disease control rate（CR ＋ PR ＋ SD） was 74.1%,one year survival rate of 54.2%,time to disease progression 4.8 months,Ⅲ~ Ⅳ degree of adverse reactions occurred rate of 30.1%;B group total efficiency of 38.3%,67.7% disease control rate,one year survival rate was 40.4%,30.9% of the time to disease progression 5 months,Ⅲ~ Ⅳ degrees incidence of adverse reactions.Two groups,A group total efficiency,disease control rate and one-year survival rate is higher than in group B（P 0.05）;time to disease progression and severe incidence of adverse reactions between the two groups showed no significant difference（P0.05）.Conclusions Vinorelbine combined with radiotherapy in the treatment of advanced non-small cell lung cancer is better,well tolerated adverse reactions.