【摘要】 目的:通过局部晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)先化疗后放疗(序贯疗法)和放化同步治疗(相伴疗法)两组的疗效比较,探讨NSCLC化疗和放疗的顺序与时机。方法:40例Ⅲ期NSCLC患者分两组。先化疗后放疗组(序贯组,20例)和放疗与化疗同步治疗组(同步组,20例)。序贯组为先诱导化疗3个周期后开始放射治疗,放疗结束后再化疗1个周期。同步组治疗方式为于第1周期化疗的同时开始放射治疗。两组患者放射治疗技术和剂量相同,总剂量60Gy/6周,照射野包括原发灶、肺门和纵隔,少数患者加照双侧锁骨上区。化疗方案:NP方案,即去甲长春花碱(NVB)+顺铂(DDP),NVB25mg/m2,d1、d8;DDP20mg/m2,d1~d4,共4个周期。结果:治疗后序贯组、同步组的缓解率分别为75%和80%,两组近期疗效差异无统计学意义,χ2=0·00,P=1·000。1、2和3年生存率序贯组分别为65%、25%和15%;同时组分别为70%、40%和30%,差异无统计学意义,χ2=0·98,P=0·322。中位生存期分别为16和18个月,t=0·986,P=0·331。3~4级骨髓抑制发生率同时组高于序贯组,但均可耐受。结论:放化同时相伴治疗NSCLC是一种较好的治疗方式。肿瘤防治杂志,2005,12(19):1499-1501更多还原

【Abstract】 OBJECTIVE:To compare the survival rates of sequential versus concurrent modalities of radiotherapy plus chemotherapy for Stage Ⅲ non-small cell lung cancer (NSCLC). METHODS: From January 1999 to December 2000, 40 patients with Stage Ⅲ NSCLC were randomized into two groups: 20 patients in the sequential group (S), 20 patients in the concurrent group (C). Radiotherapy was started after three cycles of induction chemotherapy in Group S and radiation started on the first cycle of chemotherapy in Group C. All patients received conventional radiotherapy. The total tumor dose was 60 Gy/6 weeks.Chemotherapy schedule consisted of four cycles of vinorelbine 25 mg/m~2 on day 1, 8 and cissplatin 20 mg/m~2 on day 1-4 of a 21-day cycle. RESULTS: The overall response rates (CR+PR) of Group S and Group C were 75% and 80%, respectively,χ~2=0.00,P=1.000. The median survival time was 16 months in Group S and 18 months in Group C. The 1-,2- and 3-year survival rates were 65%,25%,15% and 70%,40%, 30%, respectively in Group S and Group C, χ~2=0.98, P=0.322. Severe hematologic toxicity were significantly frequent in Group C which could be tolerated. CONCLUSION: Concurrent chemotherapy plus radiotherapy is a good way in the treatment of NSCLC.更多还原