ＴＰ方案与ＮＰ方案诱导化疗联合放疗治疗不可手术的局部晚期非小细胞肺癌

目的：探讨ＴＰ方案和ＮＰ方案诱导化疗联合放疗治疗不可手术局部晚期非小细胞肺癌（ＮＳＣＬＣ）的疗效和毒副反应。方法：６８例局部晚期ＮＳＣＬＣ（ⅢＡ期４８例，ⅢＢ期２０例）采用拆信封法随机分为ＴＰ组（紫杉醇＋顺铂）和ＮＰ组（长春瑞滨＋顺铂）。入组患者接受２个周期的ＴＰ或ＮＰ方案的诱导化疗，化疗结束后行常规分割放射治疗，总剂量为６０～６４Ｇｙ／３０～３２次。比较两组不同诱导化疗方案联合放疗治疗不可手术局部晚期ＮＳＣＬＣ的近期疗效、毒副反应和１、２年的生存率。结果：ＴＰ和ＮＰ两组的有效率分别为６９.７％和６３.６％，１年生存率分别为５４.８％和５３.３％，２年生存率分别为１６.１％和１３.３％，两组疗效均无显著性差异。毒副反应方面，ＴＰ组和ＮＰ组主要表现为骨髓抑制、恶心呕吐、放射性食管炎和放射性肺炎，均可耐受，两组无显著差异。结论：ＴＰ方案和ＮＰ方案诱导化疗联合放疗治疗不可手术局部晚期ＮＳＣＬＣ具有较好的临床疗效，化放疗毒副反应相似且均可耐受。

Results of induction chemotherapy TP and NP regimens followed by radiotherapy in unresectable local advanced non-small cell lung cancer

Objective ：To evaluate the efficacy and toxicity of induction chemotherapy plus radiotherapy for patients with unre- seetable local advanced non-small cell lung cancer（NSCLC） between TP and NP regimens. Methods：Sixty-eight patients with unre- sectable locally advanced NSCLC were retrospectively analyzed. All patients were divided into two groups, including 48 patients with stage m A and 20 patients with stage m B who had achieved 2 cycles induction. Chemotherapy and then radiation was given with a total dose of 60-64Gy at 2Gy per fraction. And a clinical control observation on effectiveness and adverse effects were carried out in two groups. Results：The short term effective rate for locally advanced NSCLC in TP group and NP group was 69. 7% and 63.6% , respectively. 1-year survival rate was 54. 8% and 53.3% ,respectively. 2-year survival rate was 16. 1% and 13.3% , respectively. The survival state and the short term effectiveness in two groups had no statistically significant difference（P 〉 0. 05）. In the adverse effects of treatment, the main toxicity included bonemarrow suppression,gastrointestinal disturbance,radiation esophagitis and radiation pneumonitis. The adverse effects showed no statistical difference in TP group and NP group, and all patients were tolerable. Conclusion：Both TP and NP regimens induction chemotherapy plus radiotherapy for unresectable locally advanced NSCLC show more effectiveness. They have no statistical difference in the short term effectiveness and in the 1,2-year survival rate. The side effects of the two regimens have no statistical difference either, while all adverse reactions are tolerable.