GP方案联合伽玛刀治疗局部晚期非小细胞肺癌临床分析

Clinical analysis of gemcitabine plus cisplatin combined with body γ-knife concurrent chemoradiotherapy in patients with locally advanced non-small cell lung cancer(NSCLC)

目的:评价GP(吉西他滨+顺铂)联合体部伽玛刀治疗局部晚期非小细胞肺癌的临床疗效及毒副反应。方法:76例局部晚期非小细胞肺癌均予以GP方案化疗联合体部伽玛刀,每个患者至少完成2周期化疗,行体部伽玛刀放疗总量DT 40-49Gy。伽玛刀治疗结束后3月评价临床疗效。结果:近期总有效率为86.84%(66/76)。1年生存率、2年生存率分别为67.11%(51/76)、42.11%(32/76)。急性放射性食管损伤(Ⅰ-Ⅱ度)发生率为19.74%(15/76),急性放射性肺损伤(Ⅰ-Ⅱ度)发生率为23.68%(18/76),Ⅲ度白细胞下降率为13.16%(10/76),Ⅳ度白细胞下降率为1.32%(1/76)。所有患者均顺利完成治疗。结论:GP方案化疗联合体部伽玛刀治疗局部晚期非小细胞肺癌近期疗效较好,毒副反应患者可以耐受,无治疗相关性死亡。

Objective：To evaluate the clinical effect and toxicoty of gemcitabine （GEM）plus cisplatin（DDP） com- bined with body γ- knife concurrent chemoradiotherapy for locally advanced NSCLC. Methods： All 76 patients were treated with GEM plus DDP combined with body γ - knife concurrent chemoradiotherapy. ＂ GP＂ project was given at least 2 cycles. Radiation was delivered with a cumulated marginal dose ranged 40 - 49Gy. Clinical effects were evalua- ted three months after the γ-knife treatment. Results：The total efficacy rate was 86.84%. Acute radiation induced lung injury was 23.68% （ Ⅰ- Ⅱ） ,cute radiation induced esophagus injury was 19.74% （Ⅰ- Ⅱ）, bone - marrow toxicity 13.16% （Ⅲ） ,bone - marrow toxicity 1.32% （ Ⅳ ）. The survival rates at 1,2 year were 67.11% and 42.11%. The toxicity of lung, esophagus and blood in 76 patients were well tolerated and all patients completed their treatment successfully. Conclusion：GEM plus DDP combined with body γ- knife concurrent chemoradiotherapy for the locally advanced NSCLC showed better effect and tolerable toxicity in most patients. No deaths related with treat- ment.