诱导化疗与巩固化疗治疗Ⅲ期NSCLC患者的疗效评价

Evaluation of efficiency of induction and consolidation chemotherapy for stage Ⅲ NSCLC

目的探讨诱导化疗和巩固化疗联合同步放化疗对无法行手术切除的Ⅲ期非小细胞肺癌(NSCLC)患者的疗效。方法选取NSCLC患者104例,随机分为诱导化疗组与巩固化疗组,各52例。诱导化疗组患者首先接受2个周期的化疗,后给予同步放化疗;巩固化疗组患者首先接受同步放化疗,随后给予2个周期的化疗。对两组患者进行3年的随访,评价并记录两组患者的不良反应发生率、肿瘤缓解和进展情况、中位生存期和中位无进展生存期(PFS)。结果诱导化疗组与巩固化疗组患者血液系统不良反应发生率比较,差异无统计学意义(P>0.05),非血液系统不良反应中肾损伤、周围神经损伤及肺炎的发生率比较,差异无统计学意义(P>0.05),巩固化疗组的食管炎发生率较高,差异有统计学意义(P<0.05)。诱导化疗组与巩固化疗组患者完全缓解、部分缓解、维持稳定、进展率比较,差异无统计学意义(P>0.05),治疗后3年内巩固化疗组患者中位生存期与诱导化疗组比较,差异有统计学意义(P<0.05),两组患者的中位PFS比较,差异无统计学意义(P>0.05)。结论以铂类化疗药物为基础的诱导或巩固化疗联合同步放化疗治疗晚期NSCLC切实可行,相比巩固化疗,诱导化疗联合同步放化疗可能使患者具有更长的中位生存期。

Objective To evaluate the efficacy of induction and consolidation chemotherapy combined with concurrent chemoradiation on stage Ⅲ NSCLC. Methods A total of 104 patients with NSCLC were divided into induction group and consolidation group, each group included 52 patients. The patients in the induction group received induction chemotherapy while the patients in the consolidation group received concurrent chemoradiotherapy followed by consolidation chemotherapy. Then the patients were followed up for 3 years. The incidence of adverse events, tumor remission and progressive rate, median survival time and median progression free survival （PFS） time were recorded. Results The incidences of adverse reactions of blood system, renal injury, peripheral nerve injury and pneumonia were similar between the two groups （P 〉 0.05）; the incidence of esophagitis in the consolidation group was higher than that in the induction group （P〈 0.05）. The rates of complete remission, partial remission, maintenance of stability and progression were similar between the two groups （P 〉 0.05）. The median survival time within 3 years after treatment in the induction group was shorter than that in the consolidation group （P 〈 0.05）, while the median PFS time was similar between the two groups （P〉 0.05）. Conclusions Cisplatin-based chemotherapy as induction or consolidation with concurrent ehemoradiotherapy can be feasible for patients with stage Ⅲ NSCLC. Induction chemotherapycombined with concurrent chemoradiotherapy may result in longer median survival time compared with consolidation chemotherapy combined with concurrent chemoradiotherapy.