MM50三维适形放疗结合多西紫杉醇同期化疗治疗晚期非小细胞肺癌的临床观察

目的:观察MM50低分割三维适形放射治疗结合多西紫杉醇同期化疗治疗晚期非小细胞肺癌的临床疗效和毒副反应。方法:时间2009年04月-2010年6月间,对52例(均为肺癌Ⅲ期)晚期非小细胞肺癌患者,均采用MM50低分割三维适形放射治疗结合多西紫杉醇同期化疗的治疗方案,以上患者均经组织学和细胞学证实。MM50(美国IBA公司生产的电子回旋加速器)三维适形放射治疗,放射源为10MV-X,给予CT模拟定位,5Gy/次,隔日一次,3次/周,共给予9-11次。先照射6-7次,后复查胸部CT,根据结果重新CT定位治疗34次。化疗方案为:多西紫杉醇25mg/m2,每周1次,连续化疗4-5周。三维适形放疗联合同步化疗。结果:近期疗效显示:肺原发灶有效率达88.46%(4.6/52),肺鳞癌有效率为93.33%(28/30),肺腺癌有效率为85.0%(17/20),其他类型50.0%(1/2)。毒副反应:急性毒副反应主要为消化道反应和轻中度的放射性食管炎,骨髓抑制,轻度的局部放射性肺炎,经过治疗均可以耐受。结论:MM50低分割三维适形放射治疗结合多西紫杉醇同期化疗方案能提高晚期非小细胞肺癌的近期疗效,且急性毒副反应无明显增加,另外该方案还值得进一步的随访研究。

Clinical Observation of Three-dimensional Conformal Radiotherapy of MM50 Combined with Docetaxol in Patients with Advanced Non-small Cell Lung Cancer

Objective:To evaluate clinic effecacy and toxicity of MM50 low split-dimensional conformal radiation therapy combined with docetaxel chemotherapy in the treatment of advanced non-small cell lung cancer.Methods:The lesions of advanced non-small cell lung cancer(PhaseⅢ) confirmed by histology and cytology were located by CT simulation and treatmented by MM50 low split three-dimensional conformal radiation therapy(9-11F of 5Gy/F,qod,3f/w)combined with chemotherapy treatment (docetaxel,ivdrip,25mg/m2)in 52 patients.Results:The short-term effective rate of primary lesions,squamous cell carcinoma, adenocarcinoma and other types carcinoma of pulmonary was respectively 88.46%(46/52),93.33%(28/30),85.0%(17/20) and 50.0% (1/2).The acute toxicity is mainly gastrointestinal reactions.Mild and moderateesophagitis,bone marrow suppression and mild local radiation pneumonitis,but the patients after treatmented can tolerated this toxicity.Conclusion:The treatment program that MM50 low split three-dimendional conformal rediation therapy combined with docetaxel chemotherapy not only insignificantly increased acute toxicity but also increased the short-term effective rate in the treatment of advanced non-small cell lung cancer.