多西他赛与顺铂联合放疗治疗晚期肺癌疗效比较

目的 比较多西他赛联合放疗和顺铂联合放疗治疗局部晚期肺癌的疗效和不良反应.方法 将98例晚期非小细胞肺癌患者随机分为两组,所有患者均给予三维适形放疗,一组(多西他赛组)放疗联合静滴多西他赛20 mg/m2周剂量,共6次；另一组(顺铂组)放疗联合静滴顺铂,每周静滴顺铂30mg/m2,共6次.两组放疗剂量均为60 ～66 GY,每次2 GY,1周5次,共5～7周.观察两组患者疗效及毒副反应.结果 多西他赛组中位生存期为17.2个月,中位局部无进展生存时间13.5个月,1、2、3年生存率分别为78.6％、35.7％和19.5％.顺铂组中位生存期为16个月,中位局部无进展生存时间16.S个月,1、2、3年生存率分别为74％、34％和20％.两组生存时间差异无统计学意义(P＞0.05).但多西他赛组胃肠道反应、晚期放疗反应较顺铂组轻.结论 多西他赛联合放疗和顺铂联合放疗治疗局部晚期肺癌疗效相当,但多西他赛联合放疗毒副反应较轻,治疗耐受性较好.

A controlled clinical trial of radiotherapy combined with docetaxol and cisplatin in the treatment of locally advanced non-small cell lung cancer

Objective To evaluate the clinical effectiveness and the major toxic effect of radiotherapy com- bined with docetaxol and cisplatin respectively in the treatment of locally advanced non-small cell lung cancer （NSCLC）. Methods 98 patients with locally advanced NSCLC were randomly divided into two groups. All of the pa- tients were treated with 3D-CRT. One group was treated combined with docetaxel, 20mg/m^2, every week, totally 6 times. The other group was treated combined with cisplatin,30mg/m^2, every week ,totally 6 times. The total dose was 60-66Gy,2Gy/F,5 times each week for 5 - 7 weeks. The clinical effect and the major toxic effect between two groups were compared. Results The median survival time in group that treated with docetaxol was 17.2 months, median progression-free survival time was 13.5 months, and the 1,2 and 3-year survival rates of the patients were 78. 6% ,35.7% and 19.5% respectively. The median survival time in group that treated with cisplatin was 16 months, median progression-free survival time was 16.5 months, and the 1,2 and 3-year survival rates of the patients were 74%, 34% and 20% respectively. The differences between two group were not statistically significant （ P 〉0. 05 ）. However,the side effect of the stomach and intestine and late radiation complication in group treated with do- cetaxol were slighter than those in group treated with cisplatin. Conclusion The clinical effect of radiotherapy com- bined with docetaxol in the treatment of locally advanced NSCLC was equal to radiotherapy combined with cisplatin. But radiotherapy combined with docetaxol has a slighter and acceptable toxic effect, which was worth the clinical ap- plication.