三维适形放疗联合多西紫杉醇化疗治疗局部晚期非小细胞肺癌临床.doc

三维适形放疗联合多西紫杉醇化疗治疗局部晚期非小细胞肺癌临床 　 作者：丁颖，张帆，杨帆，商谊，王希成 【摘要】 目的 研究三维适形放射治疗联合多西紫杉醇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　84例局部晚期非小细胞肺癌患者随机分成A组和B组，A组40例采用三维适形放射治疗，总剂量66～70Gy/33～35次，6～7周完成。B组44例采用三维适形放射治疗联合多西紫杉醇同期化疗。结果 两组患者的总有效率分别为57.9％和80.5％，其中完全缓解率分别为7.9％和29.3％，Plt;0.05，差异有显著性。两组1、2年生存率分别65.7％ 、 80.5％和39.5％ 、 53.7％（Pgt;0.05)。A组患者中位生存期为10.5个月，B组患者中位生存期为19.5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 三维适形放射治疗联合多西紫杉醇同期化疗治疗局部晚期非小细胞肺癌疗效优于单纯三维适形放射治疗。 【关键词】 非小细胞肺癌；三维适形放射治疗；化学治疗；多西紫杉醇 　　Abstract:Objective To evaluate the therapeutic efficacy and the radiation complication of three-dimensional conformal radiotherapy (3DCRT) combined Docetaxol in patients with locally advanced non-small cell lung cancer (NSCLC).Methods 84 patients with locally advanced NSCLC were randomly divided into two groups. The 40 patients in groups A received 3DCRT at the total dose of 66 to 70 Gy in 33 to 35 fractions completed in 6 to 7 weeks. The 44 patients in group B received 3DCRT combined with Docetaxol.Results The efficacy rates in group A and B were 57.9% and 80.5%,and the complete remission rates were 7.9% and 29.3% respectively,with statistical outstanding (Plt;0.05). The 1 and 2 year survival rates of the patients in group A and B were 65.7% VS 80.5%,39.5% VS 53.7% respectively,without significant difference (Pgt;0.05). The median survival time in group A and B were 10.5 months and 19.5 months 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,without significant difference.Conclusion The efficacy of 3DCRT combined with Docetaxol is better than 3DCRT in patients with locally advanced NSCLC. 　　Key words:non-small cell lung cancer（NSCLC）； three dimensional conformal radiotherapy (3DCRT)；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（non-small cell lung carcinoma,NSCLC）大约占肺癌的40％，放射治疗是治疗局部晚期非小细胞肺癌患者的