吉西他滨与奥沙利铂联合三维适形同步放化疗治疗Ⅲ期非小细胞肺癌的临床观察

目的探讨吉西他滨与奥沙利铂联合三维适形同步放化疗治疗Ⅲ期非小细胞肺癌的临床疗效及可行性。方法 60例Ⅲ期非小细胞肺癌(NSCLC)患者随机分为三维适形放疗联合吉西他滨+奥沙利铂(Gemox方案)同步化疗组(实验组,30例)与常规放疗联合吉西他滨+奥沙利铂同步化疗组(对照组,30例)。比较两组近期疗效及毒副反应差异。结果同步放化疗结束3个月后,实验组2例完全缓解、21例部分缓解,总体缓解率为76.7%;对照组无完全缓解病例、部分缓解23例,总体缓解率为76.7%,两组间总缓解率差异不显著(P>0.05)。实验组Ⅲ度、Ⅳ度肺炎发生率为10.0%,而对照组为33.3%,两组间差异显著(P<0.05)。结论三维适形放疗与常规放疗分别联合吉西他滨+奥沙利铂同步化疗相比,总体疗效相近,但前者的Ⅲ/Ⅳ度放射性肺炎发生率较低,提示该疗法可有效提高患者的治疗耐受性。

Gemcitabine with oxaliplatin chemotherapy plus three dimensional conformal radiotherapy for non-small cell lung cancer at stage Ⅲ

Objective To investigate the efficacy and practicability of gemcitabine with oxaliplatin chemotherapy plus three dimensional conformal radiotherapy （3D-CRT）for non-small cell lung cancer （NSCLC） at stage Ⅲ.Methods Sixty patients with NSCLC at stage Ⅲ were divided into observation group and control group （30 cases each） randomly.The observation group received 3D-CRT plus gemcitabine with oxaliplatin chemotherapy versus conventional radiotherapy plus gemcitabine with oxaliplatin chemotherapy in the control group.The effectiveness and side effect of the two groups were measured and compared.Results Three months after therapy,there were 2 cases of complete remission and 21 cases of partial remission and the total remission rate was 76.7％ in the observation group versus 23 cases of partial remission and 0 case of complete remission and the total remission rate was 76.7％ in the control group,and there is no significant differences in the total remission rate between the two groups （P＞0.05）.The radiation pneumonia rate of Grades 3 and 4 in the study group was 10.0％ in the observation group,significantly lower than that in the control group （33.3％） （P＜0.05）.Conclusion The efficacy of 3D-CRT between conventional radiotherapy is similar in the treatment of NSCLC at stage Ⅲ,while the former shows a lower radiation pneumonia rates suggesting that 3D-CRT could enhance the tolerance of patients to cancer therapy.