局部晚期非鳞非小细胞肺癌同步放化疗两种方案比较研究

Comparisons of two chemoradiotherapy regimens for locally advanced non-squamous and non-small cell lung cancer

目的：比较两种方案治疗局部晚期非鳞非小细胞肺癌副反应及近期疗效。方法回顾2009年3月—2013年1月42例局部晚期非鳞非小细胞肺癌患者，所有患者均接受同步放化疗，A组放疗同步培美曲塞＋顺铂化疗，B组放疗同步多西他赛＋顺铂化疗，比较A、B两组患者副反应及近期疗效。结果 A组28例患者，B组14例患者，两组副反应比较，血液毒性：白细胞减少、中性粒细胞减少、血色素降低、血小板减少无统计学差异（ P＞0．05）。非血液毒性：放射性肺损伤发生率、咳嗽发生率B组明显高于A组，有统计学差异（P＜0．05）。而其他非血液毒性：肝功能损伤、肾功能损伤、发热、呼吸困难、放射性食管炎、乏力、体重下降、消化道反应、皮肤反应均无统计学差异（P＞0．05）。近期疗效：A、B两组有效率分别为75％及71．43％，无统计学差异（P＞0．05）。结论放疗同步培美曲塞＋顺铂化疗与同步多西他塞＋顺铂化疗的两组疗效无显著差异，但培美曲塞在治疗局部晚期非鳞非小细胞肺癌副反应方面存在一定优势。

[Abstrct] Objective To compare the short -term tumor response and adverse events of two chemoradio-therapy regimens for locally advanced non -squamous non-small cell lung cancer .Methods From March 2009 to January 2013 ,we recruited 42 patients with stage ⅢNSCLC who had received three -dimensional intensity -modulated radiotherapy combined with chemotherapy .group A treated with radiotherapy combined pemetrexed plus cisplatin and group B treated with radiotherapy combined docetaxel plus cisplatin .We compared the short -term tumor response and adverse events between the two regimens .Results There were 28 cases in group A and 14 cases in group B .There were no significant differences between the two groups in hematologic toxicities ,such as leukopenia,neutropenia,anemia and thrombocytopenia.In non-hematologic toxicities,radiation pneumonitis and cough were no significances respectively （P〈0.05）.There were no significant differences in other non -he-matologic toxicities,such as liver dysfunction,renal dysfunction,fever,dyspnea,radiation esophagitis,hypody-namia,weight loss,gastrointestinal reactions and skin reactions .The response rate displayed no differences be-tween two groups .Conclusion This study reveals Pemetrexed plus cisplatin group had less non -hematologic toxicities than Docetaxel plus cisplatin group in locally advanced non -squamous non -small cell lung cancer . But there are no differences in the short -term tumor response between the two regimens .