同期放化治疗局部晚期非小细胞肺癌的临床研究

目的：观察同期放、化疗加适形(3D-CRT)补量放疗治疗局部晚期非小细胞肺癌的近期疗效和毒副反应。方法：36例局部晚期非小细胞肺癌(Ⅲa或Ⅲb期)患进入同期放化疗加适形补量组，全部患均行TP方案(紫杉醇140～160mg／m^2 d1给予；顺铂60～80mg／m^2 d1或分2～3d给予；21d为1个周期)化疗加常规放射治疗结合3DCRT补量同步治疗。结果：36例全部完成治疗计划，肺原发灶完全缓解（CR)占19．4%，部分缓解(PR)占75．0％，无变化和进展(NC PD)占5．6％，总有效率(CR PR)为94．4％；1～2级急性骨髓抑制发生率为89％，3～4级为36％。1～2级放射性食管炎和放射性肺炎的发生率分别为44％和11％，无3～4级发生率。12、18月生存率分别为78．9％、63．2％，12、18月局部控制率为68．4%、47．4％。结论：同期放化疗加适形补量治疗局部晚期非小细胞肺癌能为绝大多数患耐受，有较好的近期疗效。

Concomitant Radiochemotherapy plus Boost Radiation with Three Dimensional-conformal Radiotherapy for Locally Advanced Non-small Cell Lung Cancer

Objective: To evaluate the response and acute toxicity of concomitant radiochemotherapy plus boost radiation with three dimensional conformal radiotherapy (3DCRT) for locally non-small cell lung cancer (LANSCLC). Methods: 36 patients with LANSCLC were treated with the conventional radiotherapy and three dimensional-conformal radiotherapy combined with chemotherapy TD (Paciltaxel and DDP). Results: All patients completed treating schedule. The overall response rate (CR+PR) was 94 4% for the primary tumor. Grade 1 or 2 hematopoietic toxicity was observed in 89% of patients and grade 3 or 4 in 36%. Grade 1 or 2 acute radiation esophagitis occurred in 44% of patients and acute radiation pneumonitis developed in 11%. 12- and 18- month overall survival rates were 78 9% and 63 2%, 12-and 18-month local control rates were 68 4% and 47 4%. Conclusions: concomitant radiochemotherapy plus boost radiation with three dimensional conformal radiotherapy is well tolerated and has a better response in most patients with LANSCLC.