放化疗同步治疗Ⅲ期非小细胞肺癌.DOCVIP

临床医学论文-放化疗同步治疗Ⅲ期非小细胞肺癌 ???????????????????? 作者：杨志诚 何永萍 唐志 杨志雄 黄杰 【关键词】? 放化 ??? 摘要：目的：评价放射治疗合不同化疗方案的治疗不能手术的ш期非小细胞肺癌（NSCLC）疗效。方法：62例不能手术的ш期NSCLC患者随机分为2个组；29例化疗组每周接受1次紫杉醇30mg，顺铂30mg化疗（紫杉醇组），33例为对照组。连续5～6周，均同时配合常规分割放射冶疗（2Gy/次，5次/周），照射野包括肺部原发灶和纵隔淋巴引流区，总剂里为60～70Gy。结果：紫杉醇组总有效率（CR+PR）为82.8%，完全缓解（CR）率为10.3%,对照组总有效率为54.6%,CR率为18.0%。2个组总有效率差异有显著性意义（X2=4.41 p=0.038）。中位生存期1、2年生存率紫杉醇组分别为12.8个月，52.2%、27.3%，对照组分别为9.8个月、42.8%、18.4%，2个组差异无显著性意义。化疗的毒副作用主要是骨髓抑制和消化道反应，但均可耐受。结论：紫杉醇组绐疗不能手术的3期NSCLC近期有效率明显优于单放组，但不提高生存率。 ??? 关键词：非小细胞肺癌/放射疗法；非小细胞肺癌/药物疗法；综合治疗 ??? Concomitant Chemotherapy and Radiotherapy for Inoperable Stage 3 Non-small Cell Lung Cancer ??? Abstract：Objective： To evaluate the effect of concomitantdifferent regimens chemotherapy and radiotherapy for inoperable stage 3 non-small cell lung cancr (NSCLC),Methods Fron September 1998 to December 2000,62 patients winth inoperable stage 3 NSCLC were randomized into groups.Method：Nine patients received paclitaxel 30mg and cisplain 30 mg weekly for 5～6 weeks(paclitaxel group ),and 33 patients was control group.All patients received concomitant radiotherapy as well.Radiotherapy was given withconventional fraction in 2 Gy per fraction and five fractions per week .The total tumor doses were 60～70Gy .Treatment fields covered clinical umor and lymph node invlolved .Result： The overall response (CR+PR) rate in paclitaxel group was 82.% with a coplete response (CR) rate of 10.3%.The overall response rate in the control group was 54.6%with a CR rate of 18% .The difference of overall response rate between the two groups was statistically significant (P0.05) the median survival time ,1-,and 2-year survival rates were 12.8monthe ,52.2%and 27.2%for paclitaxel group ,and 9.8 months ,42.8% and 18.4% for the control group(P0.05).the major toxic effects of chemotherapy were gastrointestinal tract reactine and myelosuppression .Conclusion： Concomitant chemotherapy of paclitaxel plus cisplatin and radiotherapy for inoperable stage 3 NSCLC is acceptable