调强放疗联合NP方案同步与序贯治疗中晚期非小细胞肺癌的疗效观察

目的:比较调强放疗联合NP方案同步与序贯治疗中晚期非小细胞肺癌的临床疗效。方法:选择不能手术的中晚期非小细胞肺癌(NSCLC)患者80例,随机分成同步组和序贯组各40例。放疗采用调强放疗,化疗采用NP方案(盖诺 顺铂)。结果:(1)治疗总有效率比较(CR PR):同步组75·0%,序贯组45·0%,两组比较差异有显著性(P<0·05);(2)两组的总治疗时间比较:同步组平均84天,序贯组平均为140天,两组比较差异有显著性(P<0·05);(3)生存率(Kaplan-Meier法)比较:同步组1年生存率为72·4%,序贯组为52·3%,两组比较差异有显著性(P<0·05);(4)两组病人均能耐受治疗中的不良反应。结论:同步组的近期疗效明显优于序贯组,能提高患者的1年生存率,且能缩短住院周期,减轻患者的经济负担,但远期生存率的比较有待进一步观察。

Clinical study on concurrent and seguential therapy of intensity modulated radiation therapy (IMRT) combined with NP regimen chemotherapy in the treatment of middle and advanced non-small cell lung cancer patients

Objective:To evaluated the clinical effects of concurrent and sequential therapy for middle and advanced stage non-small cell lung cancer (NSCLC) use IMRT combined with NP regimen chemotherapy.Methods: 80 patients with middle and advanced stage NSCLC were randomized into two groups. 40 patients were underwent sequential therapy and other 40 patients were underwent concurrent therapy. Radiotherapy use IMRT and chemotherapy use NP regimen of vinorelbine cispatin (NP).Results:(1) The overall response (CR PR) rate was 75.0% in concurrent group and was 45.0% in sequential group.(P<0.05); (2) The treatment course were 84 days and 140 days for concurrent group and sequential group respectively (P<0.05); (3) 1-year survival rate in concurrent group was 72.4% and 53.3% in equential group respectively; (4) The toxic effects can be tolerable by all of patients.Conclusion:The concurrent chemo-radiotherapy have better overall response,1 year survival rate and shorter treatment course than the sequential chemo-radiotherapy,so it is a better method for the teratment of middle and advanced stage NSCLC,but the long term survival rate will be studied.