3DCRT联合紫杉醇加顺铂同步化疗治疗Ⅲ期NSCLC的临床疗效及安全性分析

Clinical Efficacy and Safety of 3DCRT Combined with Paclitaxel Plus Cisplatin in the Treatment of Stage Ⅲ NSCLC

目的分析3DCRT联合紫杉醇加顺铂同步放化疗治疗Ⅲ期NSCLC的临床疗效及安全性。方法选取Ⅲ期NSCLC患者65例分为2组:试验组33例,对照组32例。对照组单纯进行放疗,放疗总量为60~70 Gy,1.8~2.5Gy·d-1,每周5次,疗程为6~7周。试验组在对照组的治疗基础上给予紫杉醇注射液135 mg/m2配比500 m L质量浓度为0.045 g/m L的生理盐水加顺铂75 mg/m2配比质量浓度为0.008 g/m L的氯化钠静脉滴注,在化疗第1周、第4周静脉滴注,治疗后按实体瘤的疗效评价标准对疗效进行客观评价,再依据抗癌药物毒副作用标准对患者安全性进行分析。结果试验组治疗总有效率为88.6%,显著高于对照组的72.3%,差异有统计学意义(P<0.05)。2组均出现白细胞、血小板和血红蛋白减少,恶心呕吐,关节疼痛等不良反应,试验组Ⅲ~Ⅳ级不良反应的发生率高于对照组,2组差异有统计学意义(P<0.05)。3年内试验组生存率显著高于对照组(P<0.05)。结论 3DCRT联合紫杉醇加顺铂同步放化疗治疗Ⅲ期NSCLC相对比单纯放疗,有效率更高,但其不良反应情况更严重,选取治疗方案时应该充分考虑患者的安全性。

Objective To study the Clinical efficacy and safety of 3DCRT combined with paclitaxel and cisplatin concurrent chemoradiotherapy in the treatment of stage Ⅲ NSCLC. Methods 65 patients with stage Ⅲ NSCLC were selected and randomly divided into 2 groups：33 cases in the experimental group and 32 cases in the control group.The control group was treated with radiotherapy only,the total amount of radiotherapy was 60~70 Gy,1.8~2.5 Gy·d -1 ,5 times a week,the course of treatment was 6~7 weeks.The experimental group on the basis of the control group was given the Paclitarel injection 135 mg/m 2 ratio of 500 mL concentration of 0.045 g/mL saline plus cisplatin 75 mg/m 2 ratio of the concentration of sodium chloride injection intravenous 0.008 g/mL chemotherapy,in the first week,fourth weeks after treatment with standard intravenous infusion,the objective evaluation of the tumor effect was evaluated according to the treatment of solid tumors,according to the standard of anticancer drug adverse effect conducted safety analysis. Results The total effective rate of the experimental group was 88.6%,which was significantly higher than 72.3% of the control group,the difference was statistically significant （ P 〈0.05）.Both groups had leucopenia,thrombocytopenia,hemoglobin decrease,nausea and vomiting,joint pain and other adverse reactions,the incidence rate of stage Ⅲ～Ⅳ adverse reactions,in the experiment group was higher than the control group,the 2 groups had statistical difference（ P 〈0.05）.3-year survival rate in the experiment group was higher than the control group（ P 〈0.05）. Conclusion 3DCRT combined with paclitaxel and cisplatin concurrent radiotherapy and chemotherapy in the treatment of stage Ⅲ NSCLC compared with simple radiotherapy,has higher efficiency,but the adverse reactions are more serious,the choice of treatment should fully consider the safety of patients.