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不能手术局部晚期非小细胞肺癌同步或序贯放化疗85例临床分析
引用本文:姜勇,崔林,何学军,吴兴军,周向荣,刘建军,陈高阳,刘兴祥,李阳.不能手术局部晚期非小细胞肺癌同步或序贯放化疗85例临床分析[J].现代肿瘤医学,2017(1):56-59.
作者姓名:姜勇  崔林  何学军  吴兴军  周向荣  刘建军  陈高阳  刘兴祥  李阳
作者单位:泰州市第二人民医院肿瘤科,江苏 泰州,225500
摘    要:目的:评价不能手术局部晚期非小细胞肺癌( NSCLC)患者同步或序贯放化疗的疗效和不良反应。方法:2011年7月至2013年12月间初治接受同步或序贯放化疗的85例患者入组本研究,其中45例同步放化疗患者列入A组,40例序贯放化疗患者列入B组。A组采用放疗同步紫杉醇、顺铂化疗,B组采用单纯放疗,放疗结束后行紫杉醇、顺铂化疗。两组放疗方法相同,均为三维适型放疗,剂量60Gy/30f。对比两组治疗的疗效、不良反应和1、2年生存率。结果:85例患者均可评价疗效,随访率100%。A组与B组有效率分别为73.3%和50.0%(P﹤0.05);1年局部控制率分别为51.1%和30.0%(P﹤0.05);1年生存率分别为62.2%和42.5%(P﹥0.05);2年生存率分别为37.8%和17.5%(P﹤0.05)。A组≥Ⅲ级放射性肺炎、放射性食管炎及Ⅲ~Ⅳ级骨髓抑制的发生率分别为6.7%、11.1%和28.9%,B组分别为5.0%、10.0%和27.5%。两组不良反应相似,均可耐受。结论:局部晚期NSCLC同步放化疗的疗效优于序贯放化疗,不良反应可耐受,同步放化疗是不能手术的局部晚期NSCLC标准治疗方法。

关 键 词:非小细胞肺癌  同步放化疗  三维适形放疗  紫杉醇  顺铂

Clinical analysis of concurrent versus sequential chemoradiotherapy for 85 medically in-operable patients with locally advanced non-small-cell lung cancer
Jiang Yong,Cui Lin,He Xuejun,Wu Xingjun,Zhou Xiangrong,Liu Jianjun,Chen Gaoyang,Liu Xingxiang,Li Yang.Clinical analysis of concurrent versus sequential chemoradiotherapy for 85 medically in-operable patients with locally advanced non-small-cell lung cancer[J].Journal of Modern Oncology,2017(1):56-59.
Authors:Jiang Yong  Cui Lin  He Xuejun  Wu Xingjun  Zhou Xiangrong  Liu Jianjun  Chen Gaoyang  Liu Xingxiang  Li Yang
Abstract:Objective:To evaluate the therapeutic efficacy and treatment-related toxicity of concurrent versus se-quential chemoradiotherapy for medically inoperable patients with locally advanced non -small -cell lung cancer ( NSCLC). Methods:Clinical data of 85 patients with stage III NSCLC who received concurrent or sequential chemo-radiotherapy as initial treatment between July 2011 and December 2013 was reviewed. 45 patients who received con-current chemoradiotherapy were included in group A,40 patients who received sequential chemoradiotherapy were en-rolled in group B. Three-dimensional conformal radiotherapy(3D-CRT)was applied to all patients. Total radiothera-py doses of 60Gy in 30 fractions were delivered. Paclitaxel plus cisplatin was administered as concurrent chemotherapy in group A,as sequential chemotherapy in group B. The efficacy,toxicity,1-,and 2-year survival rate of concurrent chemoradiotherapy were retrospectively analyzed. Results:All the 85 patients could be evaluated,the follow-up rate was 100%. The response rates for group A and group B were 73. 3% and 50. 0%(P﹤0. 05). 1-year local control rates were 51. 1% and 30. 0%(P﹤0. 05). 1-year survival rate were 62. 2% and 42. 5%(P﹥0. 05),2-year sur-vival rates were 37. 8% and 17. 5%(P﹤0. 05). The rates of grade≥III radiation pneumonitis,esophagitis and hema-tologic toxicity in group A were 6. 7%,11. 1% and 28. 9%,respectively,group B were 5. 0%,10. 0% and 27. 5%. Toxic effects in two groups were tolerable for all of the patients. Conclusion:Concurrent chemoradiotherapy is effective and well tolerated for locally advanced NSCLC,it is better than sequential chemoradiotherapy as a standard therapeutic approach for patients with unresectable locally advanced NSCLC.
Keywords:non-small-cell lung cancer  concurrent chemoradiotherapy  three-dimensional conformal radiothera-py  paclitaxel  cisplatin
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