支气管动脉化疗加超分割放疗治疗局部晚期非小细胞肺癌的临床观察

目的:探讨支气管动脉灌注(BAI)化疗联合超分割放疗治疗局部晚期非小细胞肺癌(NSCLC)的疗效及不良反应。方法:67例局部晚期NSCLC患者,信封法随机分两组。观察组32例,予泰素、顺铂BAI化疗3～4个疗程后行超分割放疗,总剂量72Gy;对照组35例,静脉滴入泰素、顺铂化疗3～4个疗程后行常规放疗,总剂量60Gy。结果:观察组的有效率、1年生存率分别为65.6%(21/32)和68.8%(22/32),对照组分别为51.4%(18/35)和54.3%(19/35),差异无统计学意义,P>0.05。两组中位生存期分别为14和12.5个月。观察组2年生存率、KPS评分增高率、放射性肺损伤发生率分别为31.2%(10/32)71.9%(23/32)和9.4%(3/32),对照组分别为11.4%(4/35)、40.0%(14/35)和28.6%(10/35),差异均有统计学意义,P<0.05。结论:两组有效率相当,支气管动脉化疗加超分割放疗的远期生存率及生存质量更高放射性肺损伤发生较低,显示一定的临床优越性。

Clinical study on bronchial artiery infusion chemotherapy plus hyperfractionated radiotherapy in local advanced NSCLC

OBJECTIVE:To evaluate the efficacy and safety of bronchial artiery infusion(BAI) chemotherapy combined with hyperfractionated radiotherapy in the treatment of local advanced non-small cell lung cancer (NSCLC). METHODS: Sixty-seven cases of local advanced NSCLC were divided randomly into two groups:32 patients in the treatment group, treated by BAI chemotherapy with paclitaxel and cisplatin for three to four cycles,and then followed by hyperfractionated radiotherapy, and the total tumor dose was 72 Gy; 35 patients in the control group treated by systemic intravenous dripping chemotherapy with paclitaxel and cisplatin for three to four cycles, fllowed by conventional radiotherapy, and the total tumor dose was 60 Gy. RESULTS: The total response rate and 1-year survival rate in the treatment group were 65.6%(21/32)and 68.8%(22/32), respectively, and in the control group 51.4%(18/35)and 54.3% (19/35)respectively. There were no statistically significant differences. The median survival times in the two groups were 14 months and 12.5 months respectively.The 2-year survival rates,the improvement rate of Karnofsky performance status score and radioactive lung damage rate in the treatment group were 31.2% (10/32),71.9%(23/32)and 9.4%(3/32) respectively, and in the control group were 11.4%(4/35),40.0%(14/35)and 28.6%(10/35) respectively. There were statistically significant differences. CONCLUSIONS: The response rates are similar between the two groups. However, the group of BAI chemotherapy plus hyperfractionated radiotherapy is beneficial in the long-term survival and quality of life.The radioactive lung damage rate is lower. It shows a certainly clinical benefit.