紫杉醇／顺铂同步化疗加后程加速超分割放射治疗局部晚期非小细胞肺癌的临床观察

【目的】探讨紫杉醇／顺铂同步化疗加后程加速超分割放射治疗晚期非小细胞肺癌（NSCLC）的疗效及副反应。【方法】将64例局部晚期NSCLC患者随机分为化放组和单放组，每组32例。化放组采用化疗方案为紫杉醇顺铂同步化疗加后程加速超分割放射治疗，Co体外照射在化疗开始时同步进行。单放组仅采用后程加速超分割放射治疗。【结果】总有效率、2年生存率两组间比较差异有统计学意义（P〈0．05）。化放组白细胞减少发生率、脱发发生率与单放组比较差异有统计学意义（P〈0．05）；化放纽放射性食管炎、放射性肺炎发生率与单放组比较，差异无统计学意义（P〉0．05）。【结论】紫杉醇／顺铂同期化疗合并后程加速超分割放射治疗局部晚期NSCLC能提高近期疗效，患者在粒细胞集落刺激因子等支持治疗下，毒副反应可以耐受。

Clinical Observation on the Effect of Paclitaxel/DDP Combined with Late-course Hyperfractionated Accelerated Radiotherapy in the Treatment of Local Advanced Non-small Cell Lung Cancer

Objective] To study the result and side effects of simultaneous chemotherapy with paclitaxel/ cisplatin（DDP） in combination with hyperfractionated accelerated radiotherapy for advanced non-small cell lung cancer（NSCLC）. Methods] All 64 patients with advanced non-small cell lung cancer were randomized divided into chemoradiotherapy group（ n = 32） and radiotherapy group（ n = 32）. The ehemoradiotherapy group were subjected to chemotherapy with paclitaxel 135 mg/m2 at day 1, 22 and DDP 20 mg/m2 at day 1～5 and 22～ 26. Simultaneously, the patients were received a fraction of 2 Gy daily,5 days per week, to the total dose of 40 Gy during the conventional fractionated radiotherapy, and then followed by late~course accelerated hyperfrac- tion（LCHAR） with DT 27 Gy, to the total dose of 67Gy/6-week. The radiotherapy group was treated only by late course hyperfractionated accelerated radiotherapy. Results] The total effect, median survival time, 1 and 2-year survival rate in the chemoradiotherapy group were 87.50% 18 months, 68.75% fro and 37.50% , respectively. The total effect and 2-year survival rate in chemoradiotherapy group were improved significantly compared with those in radiotherapy group（ P 〈0.05） . The incidences of leukopenia and hair loss in ehemoradio- therapy group were higher than those of radiotherapy group（ P〈0. 05）. The incidences of radiation esophagitis and radiation pneumonitis in chemoradiotherapy group were similar to those in radiotherapy group（ P 〉 0.05）. Conclusion] Simultaneous chemotherapy with paclitaxel/DDP in combination with hyperfractionated accelerated radiotherapy for advanced non-smali cell lung cancer has an encouraging short term therapeutic effectiveness. Patients can be tolerated with the assistant treatment of G-CSF.