伽玛刀联合长春瑞滨、顺铂治疗局部晚期肺癌疗效观察简

目的：探讨体部伽玛刀联合长春瑞滨、顺铂治疗局部晚期非小细胞肺癌的临床疗效及不良反应。方法：自2008年1月-2010年7月，对101例非小细胞肺癌患者按治疗方法分为伽玛刀联合长春瑞滨、顺铂（联合组）52例和单纯应用长春瑞滨、顺铂（对照组）49例，比较两组治疗后的近期疗效、生存期及不良反应。结果：联合组、对照组有效率分别为82．69％和53．06％，两组1年生存率分别为69．23％，42．86％。联合组的急性放射性肺损伤发生率11．54％，急性放射性食管损伤发生率9．62％，均为1—2度。两组的血液毒性主要表现为白细胞下降，另外还合并有恶心、呕吐等，联合组发生几率明显高于对照组，但经过对症治疗均能顺利完成治疗。结论：伽玛刀联合长春瑞滨、顺铂治疗能显著提高局部晚期肺癌患者的近期疗效、生存时间；白细胞下降、恶心、呕吐等不良反应较单纯化疗组也明显增加，有部分患者还会出现急性放射性肺损伤，急性放射性食管损伤，但经过对症处理基本恢复正常不影响治疗。

Therapeutic effect of body gamma knife combined with vinorelbine and DDP in patients with advanced NSCLC

Objective ：To explore the clinical effects and evaluate toxicity of body gamma knife combined with vinorelbine and DDP （NP） for treatment of advanced non -small cell lung cancer （NSCLC）. Methods： Total of 101 patients with NSCLC were divided into two groups randomly：Group A -body gamma knife combined with concurrent chemotherapy （NP） （ combined therapy group） 52 cases ; Group B - chemotherapy with NP only （ control group） 49 cases. It was designed to compare the short term effect, survival time, and toxic side effects. Results： The effective rates of group A and group B were 82.69% and 53.06%. One year survival rates of the two groups were 69.23% and 42.86%. In combined therapy group acute radiation induced lung injury was 11.54%, acute radiation induced esophagus injury was 9.62% , both 1 - 2 degree. In two groups hematologic toxicity mainly was leukocyte decrease, also nausea, vomiting,in combined group obviously higher than the control group. But after symptomatic treatment patients could successfully completed treatment. Conclusion：Body gamma knife combined with vinorelbine and DDP dramatically increase the short term effect and survival time of NSCLC patients. But leukocyte decrease, nausea, vomiting also increased significantly. Some patients have acute radiation induced lung injury and acute radiation induced esophagus injury,but they don＇t influence the treatment lafter symptomatic treatment.