晚期非小细胞肺癌放化疗疗效观察

目的探讨同步放化疗与序贯化放疗治疗晚期非小细胞肺癌临床疗效及毒副反应。方法60例经病理或细胞学证实为非小细胞肺癌患者，鳞癌31例，腺癌23例，大细胞癌2例，未定型癌4例。经CT或MRI可测值病灶分期Ⅲa15例，Ⅲb30例，Ⅳ15例；年龄在21—86岁；Kamofsky评分／〉70；被随机分为A、B两组。A组30例为：序贯方法，即化疗＋放疗＋化疗；B组30例为：同步化放疗（周一-五放疗，周六化疗）＋化疗。结果近期疗效：PR＋CR：B组明显好于A组，差异有显著性。毒副作用：胃肠反应B组高于A组，骨髓抑制A组高于B组，差异有统计学意义。结论晚期非小细胞肺癌同步化放疗近期疗效明显优于序贯化放疗，而毒副作用没明显增加，更远期疗效尚待进一步观察。

Clinical observation of chemo-radiotherapy for locally advanced non-small cell lung cancer

Objective To evaluate the clinical effect and toxicity of concurrent chemo-radiotherapy and sequential chemo-radiotherapy in treating non-small cell lung cancer(NSCLC).Methods Sixty NSCLC patients,of whom 31 with squamous carcinoma,23 with adenocarcinoma,2 with large cell carcinoma and 4 with anaplastic carcinoma.These patients were also staged by CT or MRI,15 with Ⅲa stage,30 with Ⅲb stage,15 with Ⅳ stage.The age was between 21 to 86,Kamofsky apart ≥ 70.All these patients were randomly divided into two groups,the sequential chemoradiotherapy group A(n=30),thus chemotherapy + radiotherapy + chemotherapy;and the concurrent chemoradiotherapy group B(n=30),thus(Monday to Friday radiotherapy,Saturday chemotherapy)+ chemotherapy.Results Short-term effect,group B was better than group A in PR + CR.Group B was higher than group A in the toxicity of nausea and vomitting.Group A was higher than group B in the toxicity of leukocytonpenia.Conclusion Better short-term effect of locally advanced non-small cell lung cancer could be achieved by concurrent chemo-radiotherapy as compared with sequential chemo-radiotherapy though at the correspondent level of toxicity.Long-term surrival and possible specific injury await further study.