不同剂量紫杉醇同步放化疗治疗局部晚期非小细胞肺癌的临床疗效

Clinical reasearch in treating locally advanced non-small cell lung cancer with different doses of paclitaxel concurrent radiochemotherapy

目的:观察不同剂量的紫杉醇同步放化疗治疗局部晚期非小细胞肺癌的临床疗效和毒副反应。方法:109例局部晚期非小细胞肺癌分为三组,A组32例、B组38例、C组39例,三组接受放射治疗的同时,分别给予不同剂量的紫杉醇同步化疗,紫杉醇剂量分别为A组30mg/m2、B组60mg/m2、C组90mg/m2,每周1次,共4-6次。结果:三组有效率分别为68.8%、71.1%和71.8%(P>0.05),疾病控制率分别为81.3%、81.6%和82.1%(P>0.05),无进展生存期分别为(8.0±5.0)、(11.6±6.1)、(14.8±7.9)个月(P<0.05),总生存期分别为(15.4±7.6)、(18.2±8.0)、(22.0±7.6)个月(P<0.05),1年生存率无统计学意义,2年生存率差异显著。毒副反应主要为骨髓抑制、放射性食管炎和消化道反应。结论:不同剂量紫杉醇同步放化疗治疗局部晚期非小细胞肺癌,近期疗效提高,随着紫杉醇剂量的增加,远期生存率随之增加,但近期治疗毒副反应也随之增加。

Objective：To evaluate the clinical curative effects and side effects in different doses of pachtaxel con- current radiochemotherapy in treatment of locally advanced non - small cell lung cancer. Methods： A hundred and nine patients were randomized into three groups. Thirty two patients were in group A, thirty eight patients were in group B,thirty nine patients were in group C. The patients in three groups accepting radiotherapy were given different doses of paclitaxel chemotherapy concurrent concurrent respectivelyand in the same time, the doses of paclitaxel in group A was 30mg/m^2 , group B was 60mg/m^2, group C was 90mg/m^2, weekly, total 4 - 6 cycles. Results： The re- sponse rates were 68.8% ,71.1% and 71.8% respectively（P 〉0.05）. Disease control rates were 81.3% ,81.6% and 82.1% respectively （ P 〉 0.05 ）. Progression free survival was （ 8.0±5.0） months, （ 11.6 ± 6. 1 ） months and （ 14.8 ± 7.9 ） months respectively（ P 〈 0.05 ）. Overall survival was （ 15.4 ± 7.6 ） months, （ 18.2 ± 8.0） months and （22.0±7.6） months respectively（P 〈0.05）. 1 -year survival rates had no significant difference,2 -year survival rates were statistically significant. Primary side effects were myelosuppression,radiation esophagitis and gastrointestinal reaction. Conclusion ：Three doses of paclitaxel concurrent radiotherapy can improve the shot- term curative, effect^in i treatment of locally advanced non -small cell lung cancer, and the long- term survival rates increased with the dose of paclitaxel increased at the same time, but the shot - term side effects increased.