足叶乙甙,顺氯氨铂联合胸部放疗治疗局限性晚期肺鳞癌疗效观察

应用前瞻性研究方法，对５３例（Ⅲａ２０例，Ⅲｂ期３３例）局限性晚期未行手术治疗的肺鳞癌患者采用足叶乙甙及顺氯氨铂化疗，并加用胸部６０Ｃｏ照射。平均接受化疗２．４疗程，放疗总量６０Ｇｙ。结果：２例完全缓解（ＣＲ），２３例部分缓解（ＰＲ），总有效率４７．２％（ＣＲ＋ＰＲ），中位生存期１５．８个月，平均缓解期７．５个月。化疗中出现恶心、呕吐Ⅰ度者９例，Ⅱ度者４例，粒细胞减少Ⅰ度者７例，Ⅱ度者６例，Ⅲ度者１例。连续放疗组中发生放射性肺炎者占２８．２％（１１／３９），放射性心肌心包炎１例，分段放疗组中无此类副作用，认为该方案治疗肺鳞癌效果显著，分段放疗可减少副作用且疗效不受影响。

Cisplatin and Etoposide Combination Chemotherapy plus Chest Radiotherapy for Locally Advanced Squamous Cell Lung Cancer

Fifty-three patients with locally advanced squamous cell lung cancer were entered into a prospective study of cisplatin and etoposide combination (PE regimen) chemotherapy plus chest radiotherapy (RT). The patients received a mean of 2.4 courses of PE and 60 Gy of irradiation to the chest. Two patients achieved complete remission and 23 partial. An overall response rate of 47.2% was yielded.The medium survival duration was 15. 8 months and the medium duration of PR CR remission was 7. 5 months. Toxicity effect of chemotherapy included grade 1 vomiting in 9/53 cases and grade 2 in 4/54; grade 2 neutropenia in 6/53 and grade 3 in 1/53 cases. In 28.2% of 39 patients who received RT uninterruptedly developed radiation pneumonitis in addition to 1 esophagitis and 1 cardiopericarditis. No one developed adverse affects related to irradiation in patients undrwent split course RT. It Is concluded that PE-RT regimen offers superior response rate and survival than chemotherapy or radiotherapy alone. Split-course RT may decrease irradiation reactions, especially radiation pueumonitis.