伽玛刀联合紫杉醇/卡铂同步加巩固治疗局部晚期非小细胞肺癌临床观察

目的观察体部伽玛刀联合紫杉醇/卡铂同步加巩固治疗局部晚期非小细胞肺癌的临床疗效及毒副反应。方法将62例局部晚期非小细胞肺癌患者随机分为A（30例）、B（32例）两组;均给予伽玛刀同步联合紫杉醇/卡铂方案化疗（紫杉醇45 mg/m2＋卡铂AUC=2,第1天,1次/周,共6次）;B组在与A组相同治疗后,再给予巩固化疗（紫杉醇175 mg/m2＋卡铂AUC=5,第1天,1次/3周,共2周期）。比较临床疗效和毒副反应。结果近期有效率（CR＋PR）：A组76.67%,B组81.25%;1、2年生存率及中位生存期：A组分别为63.33%、30.00%和14.6个月,B组分别为68.75%、37.50%和16.9个月;两组比较,无统计学差异（P〉0.05）;毒副反应：B组明显高于A组。结论体部伽玛刀联合紫杉醇/卡铂同步治疗局部晚期非小细胞肺癌安全、有效,而在此基础上加予巩固化疗未能明显提高此类患者的生存率。

Clinical effects of concurrent chemoradiotherapy by whole body gamma knife combined with Paclitaxel plus Carboplatin followed by consolidated chemotherapy for locally advanced non-small cell lung cancer

Objective To evaluate the clinical effects and adverse reactions of concurrent chemoradiotherapy by whole body gamma knife combined with Paclitaxel plus Carboplatin followed by consolidated chemotherapy for locally advanced non-small cell lung cancer（LANSCLC）.Methods 62 LANSCLC patients were randomly divided into group A（30 cases） and group B（32 cases）.Both groups underwent concurrent chemoradiotherapy by whole body gamma knife combined with Paclitaxel plus Carboplatin（Paclitaxel 45mg/m2 and Carboplatin AUC=2,once weekly,six times in total）;group B,after concurrent chemoradiotherapy,followed by consolidated chemotherapy（Paclitaxel 175mg/m2 and Carboplatin AUC=5,three-week cycle once,two cycles）.The clinical effects and adverse reactions were compared.Results The response rates were 76.67% in group A and 81.25% in group B respectively.The 1,2 years survival rates and the median survival periods were 63.33%,30.00%,14.6 months in Group A;68.75%,37.50% and 16.9 months in Group B,there was no significant difference between the two groups（P〉0.05）.However,the side effects in group B were more than that in the group A,（P〈0.05）.Conclusion Concurrent chemoradiotherapy by whole body gamma knife combined with Paclitaxel plus Carboplatin is safe and effective for locally advanced non-small cell lung cancer,but consolidation chemotherapy based on the concurrent chemoradiotherapy may not increase the survival rate for LANSCLC patients.