三维适形放疗同期培美曲塞化疗和厄洛替尼维持治疗非鳞癌局部晚期肺癌的临床研究

目的观察三维适形放疗（3D-CRT）同步化疗并维持化疗治疗非鳞癌局部晚期肺癌的近期疗效及不良反应。方法 108例非鳞癌局部晚期肺癌患者随机分为治疗组54例和对照组54例。对照组接受3D-CRT＋TP方案（紫杉醇175 mg/m2d1,顺铂20 mg/m2d14）化疗,治疗组接受3D-CRT＋PD方案（培美曲塞500 mg/m2,顺铂20 mg/m2d14）,放疗结束后,口服厄罗替尼至病情进展,观察两组临床效果。结果治疗组疗效优于对组组（P〈0.05）;两组有效率和疾病控制率比较,差异无统计学意义（P〉0.05）。治疗组患者无进展生存时间（PFS）长于对照组（P〈0.05）。治疗组白细胞下降、血小板减少、恶心呕吐、腹泻发生率少于对照组（P〈0.05）。结论 3D-CRT同期培美曲塞化疗和厄洛替尼维持治疗非鳞癌局部晚期肺癌的临床疗效显著,且不良反应较少,是一种安全而有效的治疗手段。

Study of Three-Dimensional Conformal Radiotherapy Combined with Concurrent Pemetrexed Chemotherapy and Erlotinib Maintenance in Treatment of Non-Squamous Cell Carcinoma of Locally Advanced Lung Cancer

Objective To observe the efficacy and adverse reaction of three-dimensional conformal radiotherapy（3D-CRT） combined with concurrent chemotherapy and maintenance chemotherapy in the treatment of non-squamous cell carcinoma of locally advanced lung cancer. Methods One hundred and eight patients with non-squamous cell carcinoma of locally advanced lung cancer were randomly divided into treatment group（ 54 cases） and control group（ 54cases）. The control group received 3D-CRT ＋ TP（ taxol 175 mg /m2d1,cisplatin 20 mg /m2d1- 4） scheme,while the treatment group received 3D-CRT ＋ PD（ pemetrexed 500 mg /m2,cisplatin 20 mg/m2d1- 4） scheme. After the end of radiotherapy,the patients were given oral erlotinib until the disease progress,and the clinical effects of two groups were observed. Results The efficacy of treatment group was better than that of control group（ P 〈 0. 05）. The efficiency and disease control rates showed no significant difference between two groups（ P 〈 0. 05）. The progression-free survival（ PFS） of treatment group was superior to that of control group（ P 〈 0.05）.The incidence of leukopenia,thrombocytopenia,nausea,vomiting,diarrhea of treatment group was less than that of control group（ P 〈 0. 05）. Conclusion 3D-CRT combined with concurrent pemetrexed chemotherapy and erlotinib maintenance chemotherapy in the treatment of non-squamous cell carcinoma of locally advanced lung cancer has significant clinical effects,and less adverse reactions,which is a safe and effective therapy.