肺癌Ⅰ号方联合伽玛刀治疗Ⅲ、Ⅳ期非小细胞肺癌30例临床观察

Clinical efficacy of lung cancer prescription No. 1 combined with gamma knife in treatment of non- small cell lung cancer at stages Ⅲ and Ⅳ: a report of 30 cases

目的:观察肺癌Ⅰ号方联合伽玛刀治疗非小细胞肺癌(NSCLC)的临床疗效。方法:将90例Ⅲ、Ⅳ期NSCLC患者随机分为中药组、伽玛刀组、综合治疗组各30例,其中中药组予以肺癌Ⅰ号方治疗,伽玛刀组予以伽玛刀治疗,综合治疗组予以肺癌Ⅰ号方联合伽玛刀治疗,观察近期疗效、放疗不良反应及KPS评分并做统计学处理。结果:有效率综合治疗组为66.67%,伽玛刀组为60.00%,中药组为20.00%,提示综合组的有效率最高,但与伽玛刀组比较,差异无统计学意义(P>0.05),而中药组患者的有效率显著低于其他两组,但病情稳定的患者达到63.33%,提示不能放疗或不愿放疗的晚期非小细胞肺癌患者采用肺癌Ⅰ号方单独治疗,可相对稳定病灶;综合组与中药组相比,KPS评分改善率高,但差异无统计学意义(P>0.05),而伽玛刀组与其他两组比较,KPS评分改善率低,且差异有统计学意义(P<0.05);综合组与伽玛刀组的患者中未发生4级以上不良反应,伽玛刀组1级或2级急性放射性肺炎和急性放射性食管炎发生的比例偏高,但与综合组比较,差异无统计学意义(P>0.05),而1级或2级骨髓抑制不良反应在伽玛刀组要显著高于综合组(P<0.05),提示肺癌Ⅰ号方对放射性骨髓抑制有保护作用。结论:肺癌Ⅰ号方可减轻晚期非小细胞肺癌患者伽玛刀治疗的放疗不良反应,稳定病灶,改善患者生活质量。

Objective： To observe the clinical efficacy of lung cancer prescription No. 1 combined with gamma knife in the treatment of non- small cell lung cancer（ NSCLC）. Methods： A total of 90 patients with NSCLC at stages III and IV were randomly divided into traditional Chinese medicine（ TCM） group（ n = 30）,gamma knife group（ n =30）,and comprehensive therapy group（ n = 30）. The TCM group was treated with lung cancer prescription No. 1,the gamma knife group was treated with gamma knife,and the comprehensive therapy group was treated with lung cancer prescription No. 1 combined with gamma knife. The short- term efficacy,radiotherapy adverse reactions,and Karnofsky Performance Scale（ KPS） scores were observed and analyzed statistically. Results： The response rates（ RR） of the comprehensive therapy group,gamma knife group,and TCM group were 66. 67%,60. 00%,and 20. 00%,respectively. The RR of the comprehensive therapy group was the highest,but showed no significant difference compared with the gamma knife group（ P〉0. 05）. Compared with those of the other two groups,the RR of the TCM group was significantly lower,but 63. 33% of patients in the TCM group had stable conditions,which indicated that lung cancer prescription No. 1 could stabilize the disease in patients with advanced NSCLC who was ineligible for radiotherapy or unwilling to receive radiotherapy. Compared with the TCM group,the comprehensive therapy group had a higher improvement rate of KPS score,but showed no significant difference（ P〉0. 05）. Compared with the other two groups,the gamma knife group has a significantly lower improvement rate of KPS score（ P〈0. 05）. No patient in the comprehensive therapy group and gamma knife group showed adverse reactions more severe than grade 4. However,the gamma knife group had a higher incidence of grade 1 or 2 acute radiation pneumonia and acute radiation esophagitis,but showed no significant difference compared with the comprehensive treatment group（ P〉0. 05）. Compared with the comprehensive treatment group,the gamma knife group had a significant higher incidence of grade 1 or 2 bone marrow suppression（ P〈0. 05）,which indicated that lung cancer prescription No. 1 had a protective effect against radiation bone marrow suppression. Conclusion： Lung cancer prescription No. 1 can alleviate radiotherapy adverse reactions in patients with advanced NSCLC treated with gamma knife,and can stabilize disease and improve their quality of life.