三维适形放射治疗配合化疗治疗局部晚期非小细胞肺癌

Three dimensional-conformal radiotherapy combined with chemotherapy for locally advanced non-small cell lung cancer

目的 观察三维适形放射治疗 (3DCRT)配合化疗治疗局部晚期非小细胞肺癌的耐受性及近期疗效。方法 2 4例局部晚期非小细胞肺癌 (Ⅲa或Ⅲb期 )患者进入三维适形放射治疗加化疗组 ,全部患者均行NP方案 (N :去甲长春花碱 2 5mg/m2 第 1、8天给予 ;P :顺铂 6 0～ 80mg/m2 第 1天或分 2～ 3d给予 ;2 1d为 1个周期 )化疗加 3DCRT同步治疗。结果 2 4例全部完成治疗计划 ,肺原发灶完全缓解 (CR)占 16 .7% ,部分缓解 (PR)占 75 .0 % ,无变化和进展 (NR +PD)占 8.3% ,总有效 (CR +PR)率为 91.7% ;纵隔转移淋巴结完全缓解 (CR)占 36 .4 % ,部分缓解 (PR)占 6 3.6 % ,无变化和进展(NR +PD)占 0 % ,总有效 (CR +PR)率为 10 0 %。白细胞下降发生率为 95 .8% ,其中 3、4级白细胞下降为 5 4 .2 % ;放射性食管炎和放射性肺炎的发生率分别为 5 4 .2 %和 12 .5 % ,均为 1、2级。结论 三维适形放射治疗配合化疗治疗局部晚期非小细胞肺癌能为绝大多数患者耐受 ,有较好的近期疗效。

Objective To evaluate the acute side effects and efficacy of three dimensional conformal radiotherapy(3DCRT) combined with chemotherapy(CT) for locally advanced non small cell lung cancer(LANSCLC). Methods From Sept. 2000 to Dec.2001,24 patients with LANSCLC were treated with three dimensional conformal radiotherapy combined with chemotherapy navelbine+cisplatin NP. Results The overall response rate(CR+PR)was 91.7% for the primary tumor, and 100% for metastatic mediastinal lymph nodes.The leucopenia rate was 95.8%(54.2% grades 3,4). Acute radiation esophagitis occurred in 54.2% of patients(Grades 1,2). Acute radiation pneumonitis was observed in 12.5% of patients (Grades1,2). Conclusions 3DCRT combined with CT is well tolerated in most patients with LANSCLC. Its early responses are milder than the conventional radiotherapy combined with chemotherapy . Remote results await further follow up.