化疗联合γ-刀放疗在晚期复治肺癌治疗中的作用

Efficacy of Chemotherapy plus γ-knife Radiotherapy in the Treatment of Patients with Advanced Stage Recurrent Lung Cancer

目的探讨化疗联合γ-刀放疗在晚期复治肺癌治疗中的作用。方法83例晚期肺癌复治患者依据再次接受主要治疗方法，分为同步化放疗组（35例）、序贯化放疗组（26例）、单纯化疗组（22例）。放疗均采用γ-刀，总剂量35～50Gy。结果同步化放疗组、序贯化放疗组及单纯化疗组总有效率分别为17，1％、11．5％及31．8％，差异无统计学意义（P〉0．05）。Ⅲ期者以同步化放疗组略高（23．1％），Ⅳ期患者以单纯化疗组较高（38．5％）。总平均生存期及中位生存期以单纯化疗组最高，分别为14．2个月及9．3个月。各组先前曾行手术治疗的患者在后续复治中，生存期均长于非手术者。结论对于晚期复治肺癌患者，化疗联合γ-刀放疗同步治疗在Ⅲ期者中肿瘤缓解率略高，Ⅳ期者以单纯化疗有效率高，但各组相近。单纯化疗更有利于延长生存期。手术后复治患者生存优势明显。

Objective To investigate the efficacy of chemotherapy plus γ-knife radiotherapy in the treatment ofpatients with advanced recurrent lung cancer. Methods Eighty-three patients with advanced recurrent lung cancer were divided into three groups according to the treatment： 35 patients were treated with synchronous chemoradiother- apy, 26 patients with seqential chemoradiotherapy and 22 patients with continuous chemotherapy alone. γ-knife was used in the radiotherapy. The total dose of 35-55 Gy was given. Results The overall response rates of the synchro- nous chemoradiotherapy group, the seqential chemoradiotherapy group and the continuous chemotherapy alone group were 17.1%, 11.5% and 31.8% , respectively （P 〉 0.05）. The higher response rate was presented in theⅢ stage patients with synchronous chemoradiotherapy （23.1% ） , and in the Ⅳ stage with continuous systematized chemo- therapy alone （38.5%）. The average overall survival time and median survival time of the patients treated by chem- otherapy alone were the highest （ 14.2 and 9.3 months）. The total survival time of postoperative patients were lon- ger in the various groups than those of non-operations. Conclusion The synchronous chemoradiotherapy can partly increased the response rate of Ⅲ stage patients, and higher response rate was presented in Ⅳ stage with continuous systematized chemotherapy. Chemotherapy can prolong the survival time of the patients with lung cancer. There is survival superiority in postoperative patients.