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培美曲塞联合卡铂同期放化疗与序贯放化疗治疗晚期非小细胞肺癌的临床研究 被引量:6

Clinical study of pemetrexed combined with carboplatin concurrent chemoradiotherapy and sequential chemoradiotherapy in the treatment of advanced non-small cell lung cancer
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摘要 目的观察并探讨培美曲塞联合卡铂同步放化疗与序贯放化疗治疗晚期非小细胞肺癌的近期疗效。方法将入选的62例Ⅲ、Ⅳ期非小细胞肺癌患者随机分为同步放化疗组和序贯放化疗组。同步放化疗组患者(32例)采用培美曲塞联合卡铂方案化疗,化疗第1天开始行三维适形放疗,同步放化疗结束后2~4周继续接受原化疗方案巩固3周期。序贯放化疗组患者(30例)采用培美曲塞联合卡铂方案化疗2周期后行三维适形放疗,放疗结束后再行原方案化疗2~4周期。比较两组患者的生存状况、肺癌症状、临床疗效和不良反应发生情况。结果同步放化疗组患者的疾病进展时间为14.7个月,中位生存期为21.5个月;序贯放化疗组患者的疾病进展时间为11.4个月,中位生存期为18.2个月;两组比较差异具有显著性(P〈0.05)。同步放化疗组患者的食欲下降、咳嗽、胸痛、咯血、呼吸障碍症状评分高于序贯放化疗组(P〈0.05)。同步放化疗组患者部分缓解例数、客观缓解率、疾病控制率均明显高于序贯放化疗组(P〈0.05)。同步放化疗组患者不良反应发生率略高于序贯放化疗组,但差异无显著性(P〉0.05)。结论采取同步放化疗治疗晚期非小细胞肺癌可以提高局部肿瘤控制率,延长患者的生存期,且患者的耐受性较好。 Objective To observe the curative effect of pemetrexed combined with carboplatin concurrent chemoradiotherapy and sequential chemoradiotherapy in the treatment of advanced non-small cell lung cancer. Method A total of 62 cases of stage Ⅲ and Ⅳ non-small cell lung cancer patients were randomly divided into concurrent chemoradiotherapy group and sequential chemoradiotherapy group, 32 patients in concurrent chemoradiotherapy group were treated with pemetrexed combined with carboplatin, the first day for threedimensional conformal radiotherapy, 2 ~ 4 weeks after concurrent chemoradiotherapy, continued to receive the original chemotherapy regimens to consolidate the 3 cycle. 30 patients in sequential chemoradiotherapy group were treated with pemetrexed combined with carboplatin, three dimensional conformal radiation therapy were adopted 2 cycles after the chemotherapy regimens, then continue to receive the original chemotherapy regimens to consolidate the 2 ~ 4 weeks. The survival status, symptoms, clinical efficacy and adverse reactions of the two groups were compared. Result The time-to-progression was 14.7 months and the median survival time was 21.5 months in concurrent chemoradiotherapy group, time-to-progression was 11.4 months and the median survival time was 18.2 months in sequential chemoradiotherapy group, there were significant differences between the two groups( P〈0.05). The symptoms of appetite, cough, chest pain, hemoptysis and respiratory symptoms in concurrent chemoradiotherapy group were higher than sequential chemoradiotherapy group, and the symptoms were mild, the difference had statistical significance(P〈0.05). The partial remission rate, the objective response rate, the disease control rate in concurrent chemoradiotherapy group were significantly higher than sequential chemoradiotherapy group(P〈0.05). The incidence of adverse reactions in concurrent chemoradiotherapy group was slightly more than sequential chemoradiotherapy group, but there was no significant difference(P〉0.05). Conclusion Concurrent chemoradiotherapy in the treatment of advanced non-small cell lung cancer can improve the control rate of local tumor and the survival of patients, and the tolerance of patients is also good.
出处 《中国医学前沿杂志(电子版)》 2016年第2期21-24,共4页 Chinese Journal of the Frontiers of Medical Science(Electronic Version)
基金 贵州省科学技术基金(黔科合J字[2012]2063号)
关键词 培美曲塞 卡铂 晚期非小细胞肺癌 同步放化疗 序贯放化疗 Pemetrexed Carboplatin Advanced non-small cell lung cancer Concurrent chemoradiotherapy Sequential chemoradiotherapy
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