局限期小细胞肺癌放化疗综合治疗

[目的]研究常规放疗及加速超分割放疗联合化疗治疗局限期小细胞肺癌的近期疗效及生存期.[方法]1998年2月至2000年5月间,局限期小细胞肺癌共72例随机分为2组,常规放疗组34例和加速超分割放疗组38例.两组接受EP方案化疗2个疗程后开始放疗.常规放疗组2Gy/次,每天1次,每周5次,总量(56～60)Gv/(5.6～6)w.加速超分割组放疗1.4Gy/次,每日2次,2次间隔≥6小时,每周5日,总量56Gy/4w.放射野包括原发灶,同侧肺门、纵隔淋巴引流区.2组病人在完成放疗后继续EP方案化疗4个疗程.[结果]全组总有效率77.8%,中位生存期18个月,常规放疗组和加速超分割放疗组两组近期疗效分别为70.6%和84.2%(P＞0.05),两组1、2、3年生存率分别为76.5%、23.3%、10.9%和80.0%、32.6%、11.7%(P＞0.05).[结论]加速超分割放疗组的近期疗效及长期生存率等同于常规分割放疗组.

Chemotherapy and Radiotherapy for Patients with Limited Small Cell Lung Cancer

To evaluate therapeutic efficacy of conventional radiotherapy (CF) and accelerated hyperfractionated radiotherapy (AHF) combined with chemotherapy for limited small cell lung cancer (LSCLC).From February 1998 to May 2000,72 LSCLC patients were randomized into two groups:34 in the CF group and 38 in the AHF group.Radiation was applied after two cycles of chemotherapy in both groups.Patients in the CF group received radiation at 2Gy/F,once a day, 5 days per week to a total tumor dose of(56~60)Gy/(5.6~6)w.Patients in the AHF group received radiation at 1.4Gy/F,twice a day (interval 6 hours),5 days per week to a total tumor dose of 56Gy/4w.The radiation fields covered the primary tumor, draining hilar lymphatics, partial mediastinum areas. After the radiotherapy, the chemotherapy was continued for 4 cycles.The overall response rate (CR PR) was 77.8%.The median survival was 18 months.The response rates were 70.6% in the CF group and 84.2% in the AHF group(P>0.05).The 1-,2-,3-year survival rates were 76.5%, 23.3%, 10.9% in the CF group and 80.0%, 32.6%,11.7% in the AHF group respectively, with no significant difference (P>0.05).[Conclusion]Therapeutic efficacy of short-term response and median survival in the AHF group equals with that in the CF group.