局部晚期非小细胞肺癌同步放化疗并序贯化疗与单纯序贯放化疗的对比研究

Comparison Between Concurrent Chemoradiotherapy plus Sequential Chemotherapy and Sequential Chemoradiotherapy Alone on Locally Advanced Non-small Cell Lung Cancer Patients

目的观察局部晚期非小细胞肺癌(NSCLC)接受调强放疗(IMRT)联合同步吉西他滨和卡铂方案(GC)化疗与序贯放化疗的近、远期疗效和不良反应。方法回顾性分析不能进行手术治疗和拒绝手术治疗的局部晚期NSCLC患者65例,其中同步放化疗并序贯化疗组给予IMRT同步联合GC治疗者32例,单纯序贯放化疗组为33例给予IMRT后序贯GC治疗。通过统计分析比较两组之间的近期有效率、远期生存率和不良反应。结果两组均完成治疗,随访率100%,同步放化疗并序贯化疗组近期有效率为75%,单纯序贯放化疗组为66.7%,两组比较差异有统计学意义(P<0.05)。两组1、3年生存率相比较,同步放化疗并序贯化疗组为68.2%、20.5%;单纯序贯放化疗组为50.1%、11.3%;同步放化疗并序贯化疗组明显优于单纯序贯放化疗组(P<0.05)。两组不良反应情况对比,差异无统计学意义(P>0.05)。结论 IMRT同步联合GC方案并序贯化疗治疗局部晚期NSCLC,可以提高患者的远期生存率且不良反应可耐受。

Objective To investigate short-term and long-term efficacy and toxicity of intensitymodulated radiotherapy(IMRT) in combination with gemcitabine and carboplatin solution(GC) plus sequential chemotherapy and sequential chemoradiotherapy alone on locally advanced non-small cell lung cancer(NSCLC) patients.Methods We retrospectively analyzed 65 patients with locally advanced NSCLC who were not allowed and refused to receive operation.Thirty-two patients received IMRT with concurrent GC regimen and sequential chemotherapy,and 33 patients were treated with sequential chemoradiotherapy alone.Short-term and long-term efficacy and toxicity of two groups were compared by statistical analysis.Results All patients finished their course of treatment and the follow-up rate was 100%.The short-term response rate of IMRT combined with chemotherapy and sequential chemotherapy group was 75%,and the rate of sequential chemoradiotherapy alone group was 66.7%(P<0.05).The 1- and 3-year overall survival(OS) rates of the combination group were 68.2% and 20.5%,respectively,while those of sequential chemoradiotherapy alone group were 50.1% and 11.3%,respectively(P<0.05).No difference of toxicity between two group was observed(P>0.05).Conclusion It could increase the long-term survival rate of patients with locally advanced NSCLC by IMRT combined with GC and sequential chemotherapy and the toxicity of treatment could be tolerated.