紫杉醇单药联合三维适形放疗同步治疗老年晚期非小细胞肺癌的临床疗效观察.docVIP

紫杉醇单药联合三维适形放疗同步治疗老年晚期非小细胞肺癌的临床疗效观察 　　[摘要] 目的 观察泰素（紫杉醇）单药联合三维适形放疗同步治疗老年晚期非小细胞肺癌（NSCLC）的疗效和不良反应。 方法 选择2011年6月～2013年6月我院收治的51例70～82岁的老年晚期NSCLC患者，随机分为同步放化疗组（同步组，26例）和单纯化疗组（单化组，25例）。单化组采用单药泰素化疗，应用周剂量泰素60 mg/m2， 1次/周，连用3周，休息1周后继续下1个疗程，同步组在此基础上接受三维适形放疗（1.8～2.0）Gy/次/d，5次/周，总照射剂量 60～66 Gy。评价和分析治疗结束后两周两组的临床疗效和不良反应。 结果 同步组治疗总有效率和临床获益率分别为84.6%和96.2%，均明显高于单化组的60.0%、84.0%（P0.05）。两组的1年总生存率分别为79.2%、61.5%（P0.05），两组的1年无进展生存率分别为67.4%、40.0%（P0.05）。主要的不良反应为轻度胃肠道反应、放射性食管炎和Ⅰ～Ⅲ度骨髓抑制。 结论 泰素单药联合同步三维适形放疗治疗老年晚期NSCLC疗效较好，不良反应轻，毒副反应能耐受。 　　[关键词] 泰素；三维适形放疗；非小细胞肺癌；老年 　　[中图分类号] R734.2 [文献标识码] B [文章编号] 1673-9701（2015）11-0065-04 　　[Abstract] Objective To investigate the clinical efficacy of paclitaxel combined with three-dimensional conformal radiotherapy（3DCRT） for advanced non-small cell lung cancer（NSCLC） in the elderly. Methods From June 2011 to June 2013， 51 elderly patients with NSCLC were randomly divided into chemoradiotherapy group（n=26） and chemotherapy group（n=25）. All patients were treated with weekly 60 mg/m2 of paclitaxel intravenously for 3 weeks， and patients in the chemoradiotherapy group were also treated with three-dimensional conformal radiation （1.8～2.0 Gy per fraction， 5 times per week， total dose of 60～66 Gy）. The clinical efficacy and adverse reactions were compared between two groups. Results In chemoradiotherapy group， the response rate was 84.6% and the overall efficiency rate was 96.2%， which were higher than 60.0% and 84.0% in chemotherapy group （P0.05）. In chemoradiotherapy group， the one year survival rate was 79.2%， which was higher than 61.5% in chemotherapy group （P0.05）， so did one year progression free survival rates（67.4% vs 40.0%）（P0.05）. The main side effects were gastrointestinal toxicity， radiation esophagitis and bonemarrow suppression. Conclusion Paclitaxel combined with three-dimensional conformal radiotherapy for advanced NSCLC in the elderly are safe and effective， the toxicity is tolerable. 　　[Key words] Paclitaxel； Three-dimensional conformal ra