同步放化疗治疗局限期小细胞肺癌疗效分析

目的探讨局限期小细胞肺癌同步放化疗疗效及相关毒副作用。方法62例局限期小细胞未分化肺癌随机分成两组:序贯放化疗组和同步放化疗联合治疗组。两组患者均以CE和CAP方案交替化疗6周期,放射治疗采用6Mv-X线,总剂量50Gy/ (25f·35d)。序贯组放疗在第3周期化疗后进行,同步组放疗与第1周期化疗同时进行。结果同步放化疗组的近期完全缓解率(CR)较序贯组明显提高,分别为81%,55%,差异有显著意义(P<0.05)。3年生存率同步组和序贯组分别为35%,19%,但无统计学差异。3年远处转移率同步组与序贯组分别为55%,65%。两组毒副作用无明显差异。结论同步放化疗对局限期小细胞未分化肺癌局部控制有较好的作用,3年生存率亦有提高趋势。毒副作用可以接受,远期疗效有待于进一步观察。

Concurrent chemoradiotherapy for localized small- cell lung cancer

Objective To evaluate the responses of tumours and normal tissues to concurrent chemoradiotherapy for localized small-cell lung caner(SCLC)compared to a sequential therapy.Methods Totalhy 62 pa- tients with limited SCLC were randomized into two groups(n=31 each),one group was given sequential chemo-radio-chemotherapy(S group),and the other was given concurrent chemoradiotherapy(C group).All patients received CE/CAP scheme chemotherapy 6 cycles,and radiotherapy was delivered by 6Mv-X.The total dose was 50Gy(25f.35d).In the S group,radiotherapy was given after the third chemotherapy cycle;and in the C group,radiotherapy was delivered with the first cycle chemotherapy concurrently.Results The local complete response rate in S group and C group were 55% and 81%, respectively(P<0.05).The 3-year survival rates of S group and C group were 19% and 35%,re- spectively.The 3-year distant metastasis rates of C group and S Group were 55% and 65%,respective- ly.Analysis of severe normal tissues reactions showed no significant difference between these two groups. Conclusion For localized small-cell lung cancer,the concurrent chemoradiotherapy is significantly su- perior to the sequential in local complete response rate.It may potentially of improve the survival rate. The toxic effect and complications of concurrent therapy is acceptable.Remote local control rate and sur- vival rate await further follow-up.