局限期小细胞肺癌三维适形超分割放疗及同步化疗的临床研究

目的:观察三维适形超分割放疗及同步化疗治疗局限期小细胞肺癌(LSCLC)的疗效及不良反应。方法:50例LSCLC患者随机分为同步化疗及三维适形超分割放疗DT54Gy组(治疗组)和三维适形超分割放疗DT45Gy组(对照组)。化疗采用EP方案化疗:足叶乙甙(VP-16)100mg/m2,第1-5天;顺铂(DDP)40mg/m2,第1-3天化疗一周期,再同步放化疗,然后继续化疗,共4-6周期。放疗采用三维适形超分割放疗,1.5Gy次/,2次/d,间隔≥6h,5d周/。治疗组肿瘤量DT54Gy,对照组DT45Gy。结果:治疗组与对照组的近期有效率(CR+PR)分别为92.0%和84.0%。1、2、3年生存率分别为80.0%、40.0%、24.0%和76.0%、32.0%、16.0%(P>0.05)。中位生存期分别为24.6和22.3个月。1+2级放射性食管炎、肺炎、骨髓抑制发生率相似。结论:3DCRT超分割放疗及同步化疗在总剂量为54Gy组可获得满意的近、远期疗效,不良反应稍高但可以耐受。

Clinical outcomes of concurrent accelerated fractionation plus three-dimension conformal radiotherapy and chemotherapy for limited-stage small cell lung cancer

Objective: To evaluate the effect of EP regimen delivered concurrently with accelerated fractionation plus three-dimension conformal radiotherapy(3DCRT)for locally small cell lung cancer(LSCLC).Methods: Fifty patients with LSCLC were randomized into two groups: 25 patients received chemotherapy and accelerated fractionation plus three-dimension conformal radiotherapy DT 54Gy(treatment group),25 patients received chemotherapy and accelerated fractionation plus three-dimension conformal radiotherapy DT 45Gy(control group).Chemotherapy ragimen EP(VP-16+DDP).In both groups,patients received one cycle chemotherapy,followed by concurrent chemoradiotherapy and then received consolidate chemotherapy.Chemotherapy was used for four to six cycles of EP regimen.Radiotherapy ragimen accelerated fractionation plus three-dimension conformal radiotherapy.1.5Gy per fraction,twice daily.The total dose in treatment group and control group was 54Gy and 45Gy.Results: The overall response rate was 92.0% in treatment group,while 84.0% in control group;The 1,2 and 3 year survival rate in treatment group and control group were 80.0%,40.0%,24.0% and 76.0%,32.0%,16.0%(P>0.05).The median survival time was 24.6 and 22.3 months.There was no difference in grade 1+2 acute radiation esophagitis,pneumonitis and myelo-suppression between the two groups.Conclusion: The accelerated fractionation plus three-dimension conformal radiotherapy(DT 54Gy) and chemotherapy can achieve satisfactory short-term and long-term outcomes in patients with LSCLS and tolerable to toxicities.