体部伽玛刀联合GP方案治疗晚期NSCLC的临床研究

目的观察体部伽玛刀联合吉西他滨与顺铂(GP)方案治疗局部晚期非小细胞肺癌(NSCLC)的疗效和毒副反应。方法将病理组织学证实的60例局部晚期NSCLC患者随机分为两组,对照组应用GP方案化疗:即吉西他滨1000 mg/m2,静脉滴注,第1,8天;顺铂80 mg/m2,静脉滴注,第1天。治疗组在GP方案第1周期化疗结束后加用体部伽玛刀治疗,以后两组均21 d为一个化疗周期,连续化疗4个周期后评价疗效和毒副反应。结果治疗组31例,总有效率为77.4%,中位生存期(MST)为14.7个月,生活质量(QOL)评分治疗后比治疗前平均提高了12.5分,1年、2年、3年、5年生存率分别为61.3%、32.3%、16.1%和6.4%;对照组29例,总有效率为44.8%,MST为10.1个月,治疗后QOL评分比治疗前平均提高2.7分,1年、2年、3年、5年生存率分别为44.8%、20.7%、6.9%和0;以上结果两组比较,差异有统计学意义(P<0.05)。两组不良反应主要为血液系统毒性和胃肠道反应,其发生率差异无统计学意义(P>0.05)。结论体部伽玛刀联合GP方案治疗局部晚期NSCLC具有良好的疗效,并可显著改善患者的生活质量,延长生存期,且毒副作用轻,患者可以耐受。

Clinical Study of Body Gamma-Knife Combined with GP in the Treatment of Advanced Non-Small Cell Lung Cancer

Objective To observe the clinical efficacy and toxicities of body gamma-knife combined with GP(gemcitabine +cisplatin) regimens in the treatment of patients with the local advaced non-small cell lung cancer(NSCLC).Methods All 60 patients with histologically confirmed NSCLC were randomizedly divided into the two groups.Control group were treated with gemcitabine 1000 mg/(m2·d) on day 1,8,and cisplatin 80 mg/(m2·d) on day 1.Therapy group were added body gamma-knife after the first cycles GP regimens.21 day was a cycle for four cycles.Results Among the 31 patienes of therapy group,the overall efficacy rate was 77.4%,the median survival period and 1,2,3,5 year survival rate were 14.7 months and 61.3%,32.3%,16.1% and 6.4%,respectively.Among the 29 patienes of control group,the overall efficacy rate was 44.8%,the median survival period and 1,2,3,5 year survival rate were 10.1 months and 44.8%,20.7%,6.9% and 0,respectively.The differences between the two groups were significant(P<0.05).The main toxicities included myelosuppression and digestive reaction,the difference of incidence between the two groups was not significant.Conclusion Body gamma-knife combined with GP regimens was a safe and effective method in the treatment of advanced NSCLC and could be well tolerated in most patients.