放疗联合吉非替尼治疗局部晚期非小细胞肺癌疗效观察

目的:观察放疗联合吉非替尼与吉非替尼单药治疗局部晚期非小细胞肺癌的疗效及不良反应差异。方法:收集2010年6月至2013年6月间开封市中心医院肿瘤科53例局部晚期非小细胞肺癌患者，分为观察组29例，采用适形调强放疗技术，常规分割每次2 Gy，每日1次，每周5次，总量DT:60 Gy/30 f，同期口服吉非替尼250 mg，每日1次。对照组24例，单纯口服吉非替尼250 mg，每日1次。比较两组间疗效及不良反应的差异。结果:观察组有效率（RR）62.07%，对照组有效率（RR）33.33%，两组间差异有统计学意义（P=0.04）；观察组中位无进展生存期（PFS）19个月，中位总生存期（OS）23个月，对照组中位PFS 9个月，中位OS 18个月，两组间PFS比较，差异有统计学意义（P=0.04），OS比较差异无统计学意义（P=0.71）。放疗相关不良反应两组间差异有统计学意义（P=0.00、P=0.03），药物相关不良反应两组间差异无统计学意义（P=0.81、P=0.74、P=0.71）。结论:放疗联合吉非替尼治疗局部晚期非小细胞肺癌在有效率及无进展生存期方面优于吉非替尼单药治疗，总生存期略长，不良反应可耐受。

Treatment of local advanced non-small cell lung cancer by radiotherapy combined with gefitinib

Objective:To study the curative efficacyand adverse reactions of radiotherapy combined with gefitinib and gefitinib monotherapyin the treatment of local advanced non-small cell lung cancer.Methods:Fifty-three cases of local advanced non-small cell lung cancer treated in theoncology department of Kaifeng Central Hospital from June 2010 to May 2013 were divided into two groups according to treatment.The observation group (29 cases)received conformal radiotherapy combined with gefitinib,while the control group (24 cases) received gefitinib monotherapy only.The former was treated with conventional fractionation once a day,2 Gy daily,5 times every week,total DT:60 Gy/30 f,moreover,gefitinib 250 mg once a day.Meanwhile the latteronly toke gefitinib 250 mg once a day.The curative efficacy and adverse reactions were observed and compared.Results:The observation group got the effective rate (RR) 62.07%,and the control group 33.33%,there was statistically significant difference between the two groups (P=0.04).The progression free survival (PFS) and overall survival (OS) of observation group and control group were 19,23 and 9,18 months respectively.There was great difference in PFS (P=0.04),but no significant difference in OS (P=0.71)between the two groups.Additionally,the adverse reactions related radiotherapy were also evidently different (P=0.00,P=0.03),but those related drugs were not obviously different (P=0.81,P=0.74,P=0.71).Conclusion:The radiotherapy combined with gefitinib in the treatment of local advanced non-small cell lung cancer is more advantageous than gefitinib monotherapy in terms of effective rate and progression free survival.The overall survival time is slightly longer and the adverse reactions are tolerable.