单器官转移的非小细胞肺癌化疗并同步胸部三维放疗的临床研究

Clinical value of concurrent chemotherapy and thoracic three dimensional conformal radiotherapy for single organ metastasis of non-small cell lung cancer

目的探讨单器官转移的非小细胞肺癌化疗并同步胸部三维放疗的疗效。方法将100例确诊单器官转移的非小细胞肺癌患者信封法随机分为同步放化疗组和化疗组，各50例，两组化疗方案均采用紫杉醇加顺铂，共化疗4个周期，紫杉醇135～150mg／m^2，第1天，顺铂25mg／m^2，第2-4天静滴。同步放化疗组在化疗第1天给予同期放疗60Gy／30次／6周。结果同步放化疗组患者的治疗疗效和生活质量方面的总控制率分别为90．0％和96．0％，均明显高于化疗组（70．0％和82．0％），组间差异均有统计学意义（P〈0．05）。同步放化疗组患者的无疾病进展生存期为5．6个月，与化疗组（3．2个月）相比差异有统计学意义（P〈0．05）。同步放化疗组患者的不良反应与化疗组相比差异无统计学意义（P〉0．05）。结论单器官转移的非小细胞肺癌化疗并同步胸部三维放疗能提高患者的临床疗效和生活质量，不良反应均可耐受。

Objective To investigate the efficacy and safety of concurrent chemotherapy and tho- racic three-dimensional conformal radiotherapy for single organ metastasis of non-small cell lung cancer （NSCLC）. Methods A total of 100 patients who were diagnosed as single organ metastasis of NSCLC were envelope randomization method divided into concurrent chemoradiotherapy group （50 cases） and chemother- apy group （50 cases）. All patients received paclitaxel and cisplatin chemotherapy 4 cycles, paclitaxel 135 - 150 mg/m^2 on day 1, cisplatin 25 mg/m^2 , on day 2 - 4. Patients in concurrent chemoradiotherapy group received radiotherapy with concurrent 60 Gy/30 times/6weeks on the first day of chemotherapy. Re- sults Total effective rate of curative effect and life of quality in concurrent chemoradiotherapy group （90. 0% and 96. 0% ） were higher than those of chemotherapy group （70.0% and 82.0% ）, with signifi- cant differences （ P 〈 0. 05 ） ; Non-disease progression time of the concurrent chemoradiotherapy group were 5.6 months, significant higher than that of the control group （3.2 months） , and the differences were statis- tically significant between two groups （ P 〈 0. 05 ）. The toxicity and adverse effects between two groups were no statistically significant （ P 〉 0. 05 ）. Conclusion Concurrent chemotherapy and thoracic three-dimen- sional conformal radiotherapy could improve clinical efficacy and quality of life of single organ metastasis of NSCLC. Toxicity can be tolerated.