局部晚期非小细胞肺癌适形放射治疗与同期化疗临床观察

目的:比较单纯的三维适形放射治疗和三维适形放射治疗联合同期化疗治疗局部晚期非小细胞肺癌(NSCLC)的疗效和毒性.方法:将62例ⅢA、ⅢB期非小细胞肺癌病例随机分为单放组(31例)和同期放化疗组(31例).单放组采用三维放射治疗技术,4Gy/次,3次/周,周一、三、五照射,共17次,总剂量为68Gy;同期放化疗组的放射治疗同单放组,同时联合EP方案化疗1～3个周期.结果:同期放化疗组完全缓解率(CR)为10/31,部分缓解率(PR)为17/31,稳定率(NC)为4/31;单放组分别为6/31,16/31,9/31.急性骨髓抑制、放射性食管炎等反应,同期放化疗组略重,但无统计学意义.结论:三维适形大分割放疗合并同期化疗对局部晚期NSCLC有较好的疗效,且患者耐受性较好,远期疗效尚待进一步观察.

Three dimensional conformal radiation therapy and concurrent chemotherapy on locally advanced non-small cell lung cancer

Objective:To compare the treatment effect and toxicity of three dimensional conformal radiation therapy(3DCRT),3DCRT plus concurrent chemotherapy(3DCRT+C) on locally advanced non-small cell lung cancer. Methods:62 patients with locally advanced non-small cell lung cancer were divided randomly into two groups:1.3DCRT group,these patients received 3DCRT,the doses were delivered with 4 Gy per fraction, 3 fractions a week,the treatment were performed when monday,wednesday and friday.The total tumor dose was 68Gy/17fx.2. 3DCRT+C group: 31 patients were randomly assigned to identical 3DCRT plus CDDP and VP-16 infusion for three consecutive days as one cycle in the first and fourth weeks.Results:The overall response rates(CR+PR)of 3DCRT+C and 3DCRT were 27/31 and 22/31,NC rates of both groups were 4/31 and 6/31.There were higher incidence of the early radiation side-effects in the 3DCRT+C group,but there were no significant differences between the two groups. Conclusion:3DCRT plus concurrent chemotherapy can improve the local control in patients with locally advanced non-small cell lung cancer ,but the long-term survival needs further follow-up.