三维适形放疗联合NP方案同期化疗治疗Ⅲ期非小细胞肺癌分析

目的：观察三维适形放疗联合NP方案同期化疗治疗局部Ⅲ期非小细胞肺癌的不良反应与临床疗效。方法：37例Ⅲ期非小细胞肺癌患者接受三维适形放疗及同期化疗。观察患者的治疗完成情况,治疗期间、治疗后的不良反应及近期疗效。结果：全组患者白细胞减少发生率为91.9%。急性肝肾损伤发生率为13.5%（5/37）。急性放射性食管炎0级3例,1级11例,2级9例,3级14例。急性放射性肺炎0级2例,1级15例,2级12例,3级8例。治疗结束后完全缓解（CR）3例,部分缓解（PR）32例,稳定（SD）2例,总有效率（PR＋CR）为94.6%（35/37）。1年局部控制率为83.4%,1年生存率为75.8%,中位生存期15个月。结论：三维适形放疗联合同期化疗治疗局部Ⅲ期非小细胞肺癌可取得较好的近期疗效;不良反应较重,但可耐受。

Three Dimensional Conformal Radiotherapy Combined with Chemotherapy NP for III Stage Non-Small Cell Lung Cancer

Objective：To evaluate the acute side effects and efficacy of three dimensional conformal radiotherapy（3DCRT） combined with concurrent chemotherapy for stage III non small cell lung cancer（NSCLC）.Methods： From Sep.2006 to June.2008,37 patients with NSCLC were treated with 3D-CRT combined with concurrent chemotherapy of navelbine and cisplatin（NP）.The side effects and clinical results were observed.Results： The leucocytopenia rate was 91.9%,35 patients developed radiation pneumonitis（RP）： 15 grade 1,12 grade 2 and 8 grade 3,there was no radiation pneumonitis of grade 4.The acute radiation esophagitis were： 3 grade 0,11 grade 1,9 grade 2 and 14 grade 3.There were 3 patients（8.1%） received complete remission（CR）,32 patients（86.5%） received partial remission（PR）,the overall response rate was 94.6%（CR＋PR）.The 1-year local control rate was 83.4%,the 1-year overall survival rate was 75.8%.The median survival time was 15 months.Conclusions： 3DCRT combined with concurrent chemotherapy of NP has good short-term results on NSCLC,the side effects are obvious but could be tolerated to most patients,long term results need further observation.