多西他赛联合奥沙利铂同步化放疗治疗局部晚期非小细胞肺癌临床观察

目的 观察多西他赛联合奥沙利铂同步化、放疗治疗局部晚期非小细胞肺癌（NSCLC）的临床疗效和不良反应.方法 72例Ⅲ期NSCLC患者采用抽签法分为2组：治疗组35例进行同期放化疗,化疗在放疗开始时同期进行,用药多西他赛75 mg/m2第1天静脉滴注;奥沙利铂130 mg/m2第2天静脉滴注.21 d为1个周期,共2个周期.放疗采用X线三维适形放疗,2 Gy/次,5 次/周,总剂量60～70 Gy/30～50次,6～7周内完成.对照组37例只行三维适形放疗,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80.0%,完全缓解率22.9%;对照组总有效率56.8%,完全缓解率10.8%,2组间总有效率差异有统计学意义（x2=5.77,P＜0.05）.治疗组1、2年生存率分别为68.6%、42.9%,对照组分别为40.5%、18.9%.治疗组肿瘤进展时间平均为10.2个月,单纯放疗组为4.5个月（x2=6.34,P＜0.05）.经对症治疗后均顺利完成,治疗过程无治疗相关死亡.结论 多西他赛联合奥沙利铂同期放疗可以提高晚期非小细胞肺癌的近期疗效和远期生存率,是一种安全有效的综合治疗手段.

Clinical observation of chemotherapy with docetaxel and oxaliplatin and concurrent radiotheapy in local advanced non-small-cell lung cancer

Objective To observe the efficacy and side effects of docetaxel and oxaliplatin based chemotherapy and concurrent radiotherapy in local advanced non-small cell lung cancer(NSCLC). Methods Seventy-two patients with local advanced non-small cell lung cancer were divided into two groups randomly. Thirty-five cases in the treatment group received 2 cycles of docetaxel 75 mg/m2 on day 1 and oxaliplatin 130 mg/m2 on day 2 with 21 days for 1 cycle. And followed by three-dimensional conformal radiotherapy(3D-CRT)(2 Gy/f, 5 f/w, totally 60-70 Gy). Thirty-seven cases in the control group were treated by 3D-CRT only. The clinical response was assessed after treatment. Results Overall response rate, 1 and 2-year survival rates and average tumor progress time were higher in the concurrent chemoradiotherapy group( 80.0% ,68.6% ,42.9% and 10.2 months respectively) than those in the radiotherapy alone group (56. 8%, 40.5%, 18.9% and 4. 5 months respectively). Conclusions Docetaxel and oxaliplatin based chemotherapy and concurrent radiotherapy in local advanced non-small cell lung cancer can improve short term response rate, survival rates and average tumor progress time. The regiment is well tolerable and effective.