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医学论文范文:三维适形放疗同步TP方案化疗治疗局部晚期非小细胞肺癌
【摘要】 目的 研究三维适形放射治疗联合多西他赛同期化疗治疗局部晚期非小细胞肺癌的疗效和毒副作用。方法 63例局部晚期非小细胞肺癌患者随机分成单放组和同期组。单放组30例采用序贯2周期TP方案化疗及三维适形放射治疗,总剂量66～70 Gy/33～35次, 6～7周完成。同期组33例采用三维适形放射治疗同期化疗(多西他赛+顺铂)。结果 两组患者的总有效率分别为56. 7%和81. 8%,其中完全缓解率分别为6. 7%和27. 3%,差异有统计学意义(P<0. 05)。两组1、2年生存率分别63.5%、79.4%和40.0%、54.5% (P>0.05)。单放组患者中位生存期为11.4个月, 同期组患者中位生存期为18.9个月。两组患者早期放射反应主要为Ⅰ～Ⅱ级放射性食道炎和骨髓抑制,后期放射反应主要为Ⅰ～Ⅱ级放射性肺炎。结论 三维适形放射治疗同期TP方案化疗治疗局部晚期非小细胞肺癌，与序贯放化疗相比,可提高局部晚期非小细胞肺癌的近期疗效,生存期也有提高的趋势,但毒副反应有增加趋势。
【关键词】 非小细胞肺癌;三维适形放射治疗;化学治疗;多西他赛
An analysis of treatment effectiveness of threedimensional conformal radiotherapy combined with docetaxol in patients with locally advanced nonsmall cell lung cancerLI Chunying, WEI Lin(Dept. of Radiotherapy, Taian City Central Hospital,Taian 271000, China)Abstract:Objective: To evaluate the therapeutic efficacy and the radiation complication of threedimensional conformal radiotherapy (3DCRT) combined docetaxol in patients with locally advanced nonsmall cell lung cancer(NSCLC).Methods: 63 patients with locally advanced NSCLC were randomly divided into two groups. 30 patients in group A received 3DCRT at the total dose of 66 to 70 Gy in 33 to 35 fractions completed in 6 to 7 weeks. In the sequential chemoradiation group, two chemotherapy cycles were given before radiotherapy. 33 patients in group B received 3DCRT combined with Docetaxol. Results: The efficacy rates in group A and B were 56.7% and 81.8%, and the complete remission rates were 6.7% and 27.3% respectively. The differences were statistically significant (P<0.05). The 1 and 2- year survival rates of the patients in groupA and B were 63.5% VS 79.4%, 40.0%VS 54.5% respectively and there was no significant difference (P>0.05). The median survival time in group A and B were 11.4 months and 18. 9months respectively. The major radiation complication observed in the two groups were grade I to II acute radiation esophagitis and hematopoietic toxicity. The later radiation complication in the two groups were grade I to II radiation lung fibrosis. Conclusion: 3DCRT combined with Docetaxol is better in improving response and survival than sequential ones, but there is an ascendant tendency in adverse reaction医学全.在线www.med126.com.
Key words:nonsmall cell lung cancer; three dimensional conformal radiotherapy; chemotherapy; docetaxol
肺癌已成为目前人类死亡的主要原因,不能手术的局部晚期非小细胞肺癌(nonsmall cell lung carcinoma, NSCLC)大约占肺癌的40%,单一治疗生存率低,2年生存率仅为10%[1]。放射治疗是治疗局部晚期非小细胞肺癌患者的重要手段。近来多主张化疗、放疗综合治疗,以期延长生存期。根据局部晚期非小细胞肺癌的生物学行为和临床特点,我科于2005年10月至2007年10月进行了三维适形放射治疗联合多西他赛+顺铂同期化疗治疗局部晚期非小细胞肺癌的临床研究。结果报道如下。
