依托泊苷及顺铂同步放化疗治疗局部晚期非小细胞肺癌临床探究.doc

依托泊苷及顺铂同步放化疗治疗局部晚期非小细胞肺癌临床探究 　【摘要】 目的 研究同步放化疗对局部晚期非小细胞肺癌的疗效及毒副反应。方法 54例局部晚期非小细胞肺癌患者随机分为同步放化疗组（同步组）和单纯放疗组（单放组）。两组放疗方法相同，均采用常规分割放疗，每次2.0Gy，每周5次，肿瘤灶总量为60～70Gy。同步放化疗组采用EP方案化疗，第1天开始行放射治疗，化疗2个周期。结果 两组患者全部完成治疗计划，同步组CR 25.9%，PR 51.8%，CR＋PR 77.7%；单放组CR 7.4%，PR 48.1%，CR＋PR 55.5%；1、2、3年生存率同步组为56.4%、26.1%、13.8%；单放组为32.2%、17.9%和7.1%（P＜0.01）。同步组和单放组的中位生存时间分别为14个月和8个月（P＜0.05）。结论 依托泊苷联合顺铂放化疗同步治疗局部晚期非小细胞肺癌有较好的疗效，可提高生存率。 【关键词】 肺肿瘤 非小细胞肺癌 放疗 化疗 【Abstract】 Objective To evaluate the efficacy and toxicity of concomitant radiochemotherapy(CRCT) for the inoperable locally advanced non-small-cell lung cancer(LANSCLC). Methods 54 patients with inoperable locally advanced non-small-cell lung cancer were randomized into concomitant radiochemotherapy group(CRCT group) and radiotherapy only group(RT group).The same method of radiotherapy was used in the two groups with conventional fractionation 2.0Gy/per fraction ,five fractions a week and the total radiation dose was 60～70Gy in tumour.CRCT group received radiotherapy plus concurrent chemotherapy with DDP and Vp-16 per cycle for 2 cycles.Results The overall respones rate (CR+PR) in CRCT group was77.7%,with a complete respones(CR) rate of 25.9%. The overall respones rate in RT group was 55.5%,with a CR rate of 7.4%.The 1-,2-,and 3-year survival rates were56.4%,26.1%,13.8%.and 32.2%,17.9%,7.1% in CRCT and RT groups and the difference in the survival rate was quite significant(P＜0.01）. The median survival time was 14 months for CRCT group and 8 months for RT group(P＜0.05）.Conclusions Compared with radiotherapy,concurrent radio-chemotherapy(Vp-16 and DDP plus concurrent radiotherapy) is more effective and tolerable for the inoperable locally advanced non-small-cell lung cancer. 【Key words】 lung neoplasms;non-small-cell lung cancer;radiotherapy;chemotherapy 目前肺癌的早期诊断率低，大多数肺癌患者在确诊时已属晚期，非小细胞肺癌（NSCLC）的发病率占肺癌总数的75%～80%。对于晚期不能手术的Ⅲ期NSCLC的患者，单用化疗的近期有效率仅为30%～60%，单纯常规放疗5年生存率仅为5%～10%［1］。因此，如何提高患者的生存率成为当务之急,同步放化疗是近年来发展起来的肿瘤综合治疗的一种新的模式，对某些恶性肿瘤取得了令人瞩目的疗效，为探讨