放射治疗同时化疗治疗晚期非小细胞肺癌的疗效观察

Clinical Observances on Radiotherapy with Concurrent Chemotherapy in Non-operable Advanced Non-small Cell Lung Cancer

目的 :评价放疗同时化疗治疗Ⅲ期非小细胞肺癌 (NSCLC)的疗效以及并发症。方法 :6 8例Ⅲ期NSCLC患者随机分为放疗 +化疗组 (A组 )和单纯放疗组 (B组 )。放疗采用累及野照射 ,2 0Gy 次 ,1次 d ,5d 周。总DT(6 6～ 6 8)Gy (6 6～ 7 0 )周。化疗方案为鳞癌采用EP方案 ,腺癌采用MVP方案。结果 :总有效率化放组为 76 5 % ,单放组为 5 2 9% :两组差异有显著意义 ,χ2 =4 1 2 1 ,P =0 0 4 4。两组1、2、3年生存率分别化放组为 70 6 %、5 0 1 %、35 3% ,单放组为 5 2 9%、2 6 5 %、1 4 7% :两组间差异有显著意义 ,P <0 0 5。两组毒副反应相似 ,患者均能耐受。结论 :以顺铂为主联合化疗加放疗同时治疗晚期NSCLC可以增加局控率 ,减少远处转移率 。

Objective To evaluate the effect and complication of radiotherapy combined with concurrent chemotherapy for NSCLC patients.Methods Sixty eight patients with non operational NSCLC of grade Ⅲ were randomly divided into two groups:radiotherapy with concurrent chemotherapy (Group A) and radiotherapy alone (Group B).The involved field radiation was adopted in radiotherapy,2 0 Gy/d,5 d/w,and the total tumor dose was 66-68 Gy/6 6-7 0 weeks.The chemotherapy adopted EP region for squamous cell carcinoma and MVP region for adenocarcinoma.The frist chemotherapy cycle was undergone with radiotherapy concurrently.The second cycle was undergone at the four weeks after radiotherapy began,and another two cycles were used after radiotherapy completed.Results Total effective rates were 76 5% in Group A and 52 9% in Group B,the difference was statistically significant(χ 2=4 121, P =0 044).The 1 ,2 and 3 year survial rates were 70 6%,50 1%,35 3% in Groud A and 52 9%,26 5%,14 7% in Group B, P <0 05.Conclusion Combined chemotherapy with cisplatin in major with concurrent radiotherapy can improve tumor control rate of NSCLC,reduce the rate of matastasis,and so can improve long survival rate.