紫杉醇和顺铂联合放疗治疗老年晚期非小细胞肺癌疗效观察

目的研究紫杉醇和顺铂诱导化疗并同期联合放疗治疗不能手术的局部晚期非小细胞肺癌（NSCLC）的最佳治疗模式及疗效、预后和毒副反应。方法 82例局部晚期非小细胞肺癌患者,先给予紫杉醇和顺铂诱导化疗2周期,继之紫杉醇40 mg/m^2,静脉滴注,每周1次,并同期联合放疗,放疗结束后2月评价疗效。结果同步放疗、化疗的治疗总有效率为81.7%,1、2、3年生存率为78.6%、54.8%、38.1%,中位生存期19.6月,3年无进展生存率为26.8%（22/82）。治疗前后的QOL、KPS随机比较,差异有统计学意义（P〈0.01）。同步放疗、化疗期间入组患者其毒性可耐受,主要的急性毒副反应为白细胞下降、放射性肺炎和放射性食管炎;后期反应主要为肺纤维化和食管损伤,程度可接受,经对症处理均能耐受,均能顺利完成计划。结论每周紫杉醇联合同期放疗治疗局部晚期非小细胞肺癌有较好的疗效,值得临床应用。

Clinical study of paclitaxel and cisplain combined with radiotherapy for advanced non-small cell lung cancer in the aged patients

Objective To explore the best mode of treatment efficacy,and the side effects of induction chemotherapy with cisplatin and paclitaxel for locally advanced non-small cell lung cancer（NSCLC）.Methods Eighty-two patients with NSCLC were treated with 2 cycles of induction chemotherapy with cisplatin and paclitaxel,and then weekly intravenous drip of 40 mg/m2 pacltitaxel combined with radiotherapy.The response to the treatment was evaluated 2 months after radiotherapy.Results The overall effect of chemoradiotherapy was 81.7%.The 1-,2-and 3-year survival rates were 78.6%,54.8% and 38.1%,respectively.The median survival time was 19.6 months,and 3-year progression-free survival rate was 26.8%（22/82）.The random comparison of QOL and KPS had statistical signification（P〈0.01）.Toxicity could be tolerated during the chemoradiotherapy period.The main toxicities were the drop of peripheral blood WBC,radiation pneumonitis and radiation esophagitis.The main late phase reaction was pulmonary fibrosis and esophageal injury,which was acceptable after suitable treatment.Conclusion The regimen weekly treatment of induction chemotherapy with cisplatin and paclitaxel combined with radiotherapy for locally advanced NSCLC is effective and safe with low toxicities,which is worth clinical application.