【摘要】 目的观察三维适形放疗联合吉西他滨和顺铂同步化疗治疗局部晚期非小细胞肺癌的近期疗效及副反应。方法36例Ⅲ期非小细胞肺癌患者(Ⅲa期22例,Ⅲb期14例),接受DT60~70Gy放疗,放疗中给予吉西他滨600mg/m2和顺铂20mg/m2,每周1次,共4~6周,放化疗在同一天开始进行。结果32例患者完成了60~72Gy放疗,2例放疗总量56Gy,2例放疗总量58Gy。34例完成了4~6周化疗,2例完成了2周化疗。肺原发灶CR为11.1%(4/36),PR为72.2%(26/36),有效率为83.3%(30/36),和NC和PD分别为11.1%(4/36)和5.6%(2/36),放射性肺炎发生率为25.0%(9/36),放射性食管炎发生率为36.1%(13/36),白细胞下降发生率为88.9%(32/36),36例患者的中位随访期为18.4个月,1、2年生存率分别为77.8%(28/36)、55.6%(20/36)。结论三维适形放疗联合吉西他滨和顺铂同步治疗局部晚期非小细胞肺癌近期疗效较好,副反应能为大多数患者耐受,但远期疗效有待进一步随访。更多还原

【Abstract】 Objective To study the toxicities and efficacy of concurrent gemcitabine plus cisplatin combined with three-dimensional conformal radiotherapy for stage Ⅲnon-small cell lung cancer(NSCLC).Methods Thirty-six patients with pathologically diagnosed non small cell lung cancer (NSCLC) received radiotherapy and concurrent chemotherapy.There were 22 patients with Ⅲa and 14 patients with Ⅲb disease.Radiotherapy was given a total of 60～70 Gy in conventional fractionation.Chemotherapy included gemcitabine,600mg/m2 and cisplatin,20 mg/m2,once every week.Results Thirty-two patients received a total dose of 60～72 Gy.Two patients received 56 Gy and another two patietns received 58 Gy.Thirty-four patients received 4～6 weeks of chemotherapy,while two patients received only 2 weeks of chemotherapy.The overall response rate (CR+PR),complete response rate (CR),partly response rate (PR) were 83.3%(30/36),11.1%(4/36) and 72.2%(26/36),respectively.Acute radiation-pneumonia,acute radiation-esophagitis and leukocytopenia were seen in 25.0%(9/36),36.1%(13/36) and 88.9%(32/36) patients,respectively.The median follow-up duration was 18.4 months.The 1-and 2-year overall survival rates were 77.8%(28/36) and 55.6%(20/36),respectively.Conclusion Concurrent gemcitabine and cisplatin combined with three-dimensional conformal radiotherapy for stage Ⅲ non-small cell lung cancer is effective and well tolerated.Long-term results need further study.更多还原