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三维适形放疗加紫杉醇卡铂周方案同步
治疗Ⅲ期非小细胞肺癌的疗效观察

郝澄澄,刘慧忠,王俊超,王湘连,田光亮
  

  1. (山东大学齐鲁医院肿瘤中心放疗科, 济南 250012)
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2009-02-16 发布日期:2009-02-16

Threedimensional conformal radiotherapy with weekly paclitaxel and
carboplatin for local advanced nonsmall cell lung cancer

HAO Chengcheng, LIU Huizhong, WANG Junchao, WANG Xianglian, TIAN Guangliang
  

  1. (Cancer Center, Qilu Hospital of Shandong University, Jinan 250012, China)
  • Received:1900-01-01 Revised:1900-01-01 Online:2009-02-16 Published:2009-02-16

摘要: 目的观察三维适形放疗联合紫杉醇卡铂周方案同步化疗局部晚期非小细胞肺癌的疗效及毒副反应。方法将94例局部晚期非小细胞肺癌患者分为同步A、B组及序贯组,分别为33、29、32例。均采用三维适形放射治疗,2?Gy/次,总剂量70?Gy。同步A组采用紫杉醇50?mg/m2+卡铂AUC1.5,给药时点1、8、15、29、36、43?d。同步B组方法同A组,但紫杉醇为40?mg/m2。序贯组采用紫杉醇150?mg/m2卡铂AUC5,21?d为1周期,放疗前使用2个周期。结果同步A、B组、序贯组的有效率〔完全缓解(CR)+部分缓解(PR)〕分别为81.8%、79.3%、56.2%。序贯组与同步组的差异有统计学意义。3组的中位生存期分别为18.8、17.6、15.6个月;1、2年总生存率分别为74.0%、41.0%;72.0%、39.0%;69.0%、35.0%,组内差异无统计学意义。3组的Ⅱ、Ⅲ级急性放射性食管炎、Ⅱ、Ⅲ级急性放射性肺炎和Ⅱ、Ⅲ级骨髓抑制发生率分别为60.6%、24.2%、42.4%; 58.6%、24.1%、44.8%; 40.6%、21.9%、18.8%。结论紫杉醇加卡铂周方案联合同步放疗,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: 癌,非小细胞肺, 放射疗法,适形, 化学疗法,辅助, 紫杉属

Abstract: To evaluate the efficacy and toxicity of threedimensional conformal radiotherapy with weekly paclitaxel and carboplatin for local advanced nonsmall cell lung cancer (NSCLC). Methods94 patients with local advanced NSCLC were randomly divided into three groups: the concurrent chemoradiation group A(n=33), the concurrent chemoradiation group B(n=29), and the sequential chemoradiation group(n=32). The three groups were all given 3DCRT at 2?Gy/f to a total dose of 70?Gy. In the concurrent chemoradiation group A, paclitaxel 50?mg/m2 and carboplatin of 1.5AUC/cycle were given on day 1, 8, 15, 29, 36 and 43. In the concurrent chemoradiation group B, except for paclitaxel 40?mg/m2, paclitaxel 50?mg/m2 and carboplatin of 1.5AUC/cycle were also given on the above mentioned days. In the sequential chemoradiation group, two chemotherapy cycles were given before radiotherapy. Paclitaxel 150?mg/m2 and carboplatin 5 AUC/cycle were administered on day 1 and 21. ResultsThe effective power 〔complete response(CR) +partial response(PR)) of concurrent chemoradiation groupA, B, and sequential chemoradiation group was 81.8%, 79.3%, and 56.2%. The median survival time was 18.8 months for the concurrent chemoradiation group A, 17.6 months for the concurrent chemoradiation group B and 15.6 months for the sequential chemoradiation group. The 1 and 2year survival rates in the three groups were 74.0% and 41.0%, 72.0% and 39.0%, and 69.0% and 35.0%, respectively. ⅡⅢ grade of esophagitis, pneumonia and leukocytonpenia in the three groups were 60.6%, 24.2%, and 42.4%; 58.6%, 24.1% and 44.8%; and 40.6%, 21.9% and 18.8%, respectively. Conclusion

中图分类号: 

  • R734.2
[1] 阮永威,金星,侯连泽. 表阿霉素、多西紫杉醇、5-氟脲嘧啶序贯对乳腺癌细胞凋亡的影响[J]. 山东大学学报(医学版), 2006, 44(7): 750-753.
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