多西他赛联合三维适形放疗治疗老年局部晚期非小细胞肺癌70例

目的]观察多西他赛联合三维适形放疗（3D-CRT）治疗老年局部晚期非小细胞肺癌（NSCLC）的疗效与安全性。方法]2005年5月至2009年1月共70例（ⅢA期37例,ⅢB期33例）老年局部晚期NSCLC患者入组,其中68例完成放化疗,多西他赛70mg/m2,d1,静脉滴注,28d为1个周期,共2～3个周期;化疗第2d行3D-CRTDT56～64Gy/28～32f,38～44d。结果]68例中CR13例（19.12%）,PR38例（55.88%）,SD7例（10.29%）,PD10例（14.71%）,总有效率（RR）75.00%,中位生存时间（MST）13.75个月（5～48个月）,中位肿瘤进展时间（TTP）10.50个月（4～36个月）。鳞癌的TTP、MST优于腺癌（P值均〈0.001）;ⅢA期TTP、MST优于ⅢB期（P值均〈0.001）。毒副反应主要表现为骨髓抑制、放射性食管炎、放射性肺炎、放射性皮炎、脱发、消化道反应、周围神经毒性及皮疹等。结论]多西他赛联合3D-CRT治疗老年局部晚期NSCLC疗效较好,毒性反应可以耐受,为老年局部晚期NSCLC患者综合治疗的有效方案。

Docetaxel Combined with Three-dimensional Conformal Radiotherapy in the Treatment for 70 Elderly Patients with Locally Advanced Non-small Cell Lung Cancer

Purpose] To investigate the response and toxicity of concurrent chemoradiotherapy and sequential chemoradiotherapy for NSCLC. Methods] Sixty-seven cases with locally advanced NSCLC were divided into concurrent chemoradiotherapy（CC） group（n=35） and sequential chemoradiotherapy （SC） group （n=32）. Patients in CC group received paclitaxel 40mg/m2 and carboplatin AUC=2, d1, and 3DCRT was begun at d1, once a week. Patients in SC group received 2 cycles chemotherapy before 3DCRT, chemotherapy with paclitaxel 150mg/m2 and carboplatin AUC=6, 21 days as a cycle, and 3DCRT was begun at d42. Results] The overall response rate in CC group and SC group was 77% and 56%, 1-year survival rate was 76% and 66%, 2-year survival rate was 39% and 32% respectively, without significant difference （P0.05）. Toxicity between the two groups had no significant difference （P0.05）. The local recurrence rate in CC group and SC group was 20% （7/35） and 31% （10/32）, with significant difference （χ2=4.521, P=0.033）. Conclusion] Concurrent chemoradiotherapy for locally advanced NSCLC is effective, but it may increase toxicity.