长春瑞滨每周方案同期适形放疗治疗老年局部晚期非小细胞肺癌的疗效观察

目的评价长春瑞滨化疗并同期X线三维适形放疗（3D—cRT）综合治疗Ⅲ期老年局部晚期非小细胞肺癌的疗效及毒副作用。方法60例Ⅲ期老年非小细胞肺癌患者随机分为2组：治疗组30例，化疗方案，长春瑞滨10mg／m^2，每周1次，连用7周。同期行全程X线三维适形放疗DT：（66—70）Gy／33—35次，2Gy／次，5次／周；对照组30例，只行三维适形放射治疗，具体剂量、分割方式同治疗组。治疗完成后评价疗效和不良反应。结果治疗组总有效率（CR＋PR）76．6％（23／30），完全缓解率（OR）23．3％（7／30）；对照组总有效率50．0％（15／30），完全缓解率13．3％（4／30），两组间总有效率差异有显著性（χ2=4．59，0．01〈P〈0．05）。中位生存期治疗组和对照组分别为13个月和11个月，1、2年生存率治疗组分别为63．3％（19／30）、33．3％（10／30）；对照组分别为50．0％（15／30）、23．3％（7／30），两组间差异无显著性（P〉0．05）。放化疗的毒副反应主要是消化道反应、骨髓抑制、放射性肺炎和放射性食管炎，但皆可耐受。结论全程X线三维适形放疗并同期长春瑞滨化疗综合治疗Ⅲ期老年非小细胞肺癌可明显提高近期疗效．远期疗效略有提高，但无统计学差异，值得进一步研究。

Conformal Radiotherapy with weekly concurrent Vinorelbine in the Treatment of aged Patients with Locally Advanced Non-small Cell Lung Cancer

Objective To evaluate the efficacy and toxicities conformal radiotherapy combined with weekly Vinorelbine in the treatment of elderly patients with stage m non small cell lung cancer. Methods 60 aged patients with stage m non-small cell lung cancer were randomly divided into 2 groups ： The 30 patients in the treatment group were treated by 3 dimensional conformal radiotherapy combined with weekly vinorelbine, which included conformal radiotherapy of 66 -70 Gy in conventional fraction, and weekly vinorelbine 10 mg/m^2 throughout the radiotherapy periods. The patients in the control group were treated by radiotherapy alone, which was given in the same technique as in the treatment group. Results The total response rate （CR/PR） was 76.6% （23/30） and the complete response rate （ CR）was 23.3% （7/30） in the treatment group. The total response rate was 50.0% （15/30） and the complete response rate was 13.3% （4/30） in the control group. There was a significant difference （ χ2 = 4.59,0.01 （P 〈 0.05 ） of the total response rate between the two groups. The median survival time was 13 months and 11 months in the treatment and the control group. The 1 and 2 year survival rate were 63.3% （19/30） ,33.3% （10/30） and 50.0% （15/30） ,23.3 % （ 7/30 ）, respectively, and this difference was not statistically significant （ P 〉 0.05 ）. The main toxicities included gastrointestinal reaction, bone marrow suppression, radiation pneumonitis and radiation esophagitis. All the toxicities were well tolerated. Conclusion Confromal radiotherapy combined with concurrent weekly vinorelbine could improve the short term efficacy of aged patients with non small cell lung cancer.