紫杉醇化疗联合同步三维适形放疗治疗局部晚期非小细胞肺癌

目的：观察紫杉醇同步化疗增敏联合三维适形放疗治疗局部晚期非小细胞肺癌的耐受性及近期疗效。方法：自2001年9月～2003年12月37例局部晚期非小细胞肺癌患者随机进入紫杉醇化疗增敏联合三维适形放疗治疗组(17例)及单独三维适形放疗(3DCRT)治疗组(20例)。紫杉醇化疗联合三维适形放疗组患者均行紫杉醇化疗(每周给30mg／m^2)，加3DCRT同步治疗。放射治疗剂量为70～74Gy。结果：37例患者全部完成治疗计划。紫杉醇化疗增敏联合三维适形放疗治疗组：肺原发灶完全缓解(CR)占11．8％，部分缓解(PR)占70．6％，无变化和进展(NC PD)占17．6％，有效率(CR PR)为82．4％。单独三维适形放疗治疗组：肺原发灶完全缓解(CR)占5％，部分缓解(PR)占60％，无变化和进展(NC PD)占35％，有效率(CR PR)为65％。化疗联合三维适形放射治疗与单独三维适形放疗治疗组患者2～3级急性放射性食管炎、2～3级急性放射性肺炎和2～3级白细胞减少发生率分别为58．8％(10／17)和40％(8／20)，23．5％(4／17)和15％(3／20)，41．2％(7／17)和10％(2／20)。中位随访期为24个月(5～31个月)。结论：紫杉醇化疗联合三维适形放疗治疗局部晚期非小细胞肺癌近期疗效较好，毒性也有所增加，但能为绝大多数患者耐受。远期疗效有待进一步随访。

Paclitaxel Combined with Three Dimensional-conformal Radiotherapy for Locally Advanced Non-small Cell Lung Cancer

Objective: To evaluate the acute side effects and efficacy of paclitaxel combined with three dimensional-conformal radiotherapy for locally advanced non-small cell lung cancer. Methods: From Sep 2001 to Dec 2003, 37patients with locally advanced non-small cell lung cancer were treated with three dimensional-conformal radiotherapy combined with(group 1) or without paclitaxel (group 2).Results: The overall response rate(CR+PR), complete response rate (CR),partly response rate (PR) in group 1 and group 2 were 82.4% and 65%, 11.8% and 5%,70.6% and 60%,respectively. Grade 2~3 acute radiation-esophagitis pneumonia and leukocytopenia occurred in group 1 and group 2 were 58.8%(10/17) and 40%(8/20), 23.5%(4/17)and 15%(3/20),41.2%(7/17)and 10%(2/20), respectively.The median follow-up duration was 24(5~31) months. Conclusion:Paclitaxel combined with three dimensional-conformal radiotherapy was well tolerated and improved response rate in most patients with locally advanced non-small cell lung cancer.