【摘要】 目的探讨老年晚期非小细胞肺癌(NSCLC)的有效综合治疗方案。方法将163例≥70岁Ⅲ期NSCLC患者随机分为3组。放疗组54例,常规分割前后野照射40 Gy后缩野照射至60 Gy,有淋巴结转移者加照60 Gy;化疗组54例,采用紫杉醇联合卡铂低剂量持续给药治疗6周期,4W为一周期;同步组55例,化疗开始第9天开始放疗,方法同上两组,直至疗程结束。结果同步组、放疗组、化疗组有效率分别为65.5%、57.4%、46.3%,同步组疗效明显优于化疗组(χ2≈4.0581,P<0.05);与放疗组接近(χ2≈0.7450,P>0.05),其1、2、3年生存率分别为65.5%、38.2%、18.2%,45.5%、20.3%、7.4%,51.9%、24.1%、11.1%,中位生存期分别为15、10、12个月,同步组与另两组比较差异有统计学意义(P<0.05)。同步组不良反应较多且重,但能耐受,均未影响治疗计划。结论紫杉醇联合卡铂低剂量6周期化疗同步放疗治疗老年晚期NSCLC能明显提高有效率和生存率,不良反应加重但能耐受,是治疗老年晚期NSCLC安全有效的综合治疗方案。更多还原

【Abstract】 Objective To investigate effective integrated treatmen program of elderly patients with advanced non-small cell lung cancer(NSCLC).Methods 105 cases eldrely patients(≥70 years)with advanced NSCLC Were randomly divided into three groups.54 cases were in radiotherapy only group,which was used conventional fractionation 40 Gy,followed by reduced fields with a total dose of 60 Gy.The patients with lymph node metastasis increased according to 60 Gy.The patients with lymph node metastasis increased according to 60 Gy.54 cases were in chemotherapy alone group,which was treated with low dose of paclitaxe plus carboplatin 4 weeks per cycle for 6 cycles.The same method of radiotherapy and chemotherapy,radiotherapy was used.Results Response rate of concomitant radiochemotherapy group,radiotherapy group and mchemotherapy group was 65.5%,57.4% and 46.3%,respectively.The response rate of concomitant radiochemotherapy group significantly superiotde to chemhtherapy gtoup(χ2≈4.0581,P<0.05),and closed to radiotherapy group(χ2≈0.7450,P>0.05).1,2,3-year survival rates of cincomitant radiochemotherapy group were 65.5%,38.2% and 18.2%;one of chemotherapy group were 45.5%,20.3% and 7.4%;one of radiotherapy group were 51.9%,24.1% and 11.1%.The median survival time was 15,10 and 12 months for three groups.There was significant difference between the concomitant radeochemotherapy group and other groups(P<0.05).Patients in the cincomitant radiochemotherapy group had more adverse toxicity,but they could be tolerated,neither affected the treatment plan.Conclusion Synchronic radio-chemical therapy(low dose of paclitaxe plus carboplatin for 6 cycles and radiotherapy) may increase effective and survival rate of elderly patients with locally advanced non-small cell lung cancer.更多还原