摘要
目的 回顾分析诱导化疗后调强放疗治疗局部进展期非小细胞肺癌(NSCLC)的临床疗效和放化疗相关不良反应.方法 59例局部进展期(ⅢA和ⅢB期)NSCLC均采用诱导化疗后调强放疗治疗方案,化疗采用顺铂+紫杉醇方案2周期,3周重复,放疗剂量60 ~ 70.4Gy,1.8 ~ 2.2Gy/次,每周5次.结果 (1)全组患者中位生存时间为19个月,1年总生存率(OS)为81%,2年OS为36%,3年OS为25%.(2)3级急性放射性肺炎发生率为5%(3/59),3级晚期放射性肺损伤发生率为3% (2/59),3级急性放射性食管炎5%(3/59),3、4级急性血液学毒性为29%(17/59).结论 诱导化疗后调强适形放疗用于局部进展期NSCLC治疗,患者临床疗效较单纯放疗好,放疗相关性肺炎、食管炎发生率较同步放化疗方案低,适合一般状况较差的老年患者.
Objective To retrospectively analyze clinical efficacy and chemo-radiotherapy-correlated toxicity of locally advanced NSCLC getting induction chemotherapy followed intensity-modulated radiotherapy.Methods Fifty-nine patients with NSCLC (phase Ⅲ A and Ⅲ B) were treated with induction chemotherapy and intensity-modulated radiothedrapy.Induced chemotherapy with cisplatin and taxinol was carried out for 2 circles.The prescription dose was 60-70.4Gy,dose per fraction was 1.8-2.2Gy.Results (1) Median survival period was 19 months.One-year OS was 81%,2-year OS was 36%,and 3-year OS was 25%.(2) The occurrence rate of acute chemoradiation-induced pneumonitis of Grade 3 or higher and pulmonary fibrosis was 5% (3/59) and 3% (2/59),respectively.Acute chemoradiation-induced esophagitis of Grade 3 and Grade3,4 hematotoxicity were 5 % (3/59) and29% (17/59),respectively.Conclusion IMRT after induction chemotherapy can provide better OS results than radiotherapy alone for locally advanced NSCLC patients.The rate of chemoradiation-induced pneumonitis and esophagitis was lower compared with concurrent chemoradiotherapy.
出处
《医学研究杂志》
2014年第4期95-99,共5页
Journal of Medical Research