【摘要】 目的观察和评价吉西他滨联合顺铂(GP)同步放疗治疗Ⅲ期非小细胞肺癌的耐受性和近期疗效。方法42例Ⅲ期非小细胞肺癌患者随机分为2组,放疗组21例先采取常规前后野对穿照射,剂量40Gy后改为调强适形放射治疗,包括原发灶和转移淋巴结,25～30Gy/10～12次,总剂量为65～70Gy。同步放化疗组的放射治疗同单纯放疗组,化疗采用吉西他滨1g/m2第1、8天静脉滴注,顺铂30mg/m2·d,第1～3天静脉滴注,21d为1个化疗周期,化疗共4～6个周期。结果同步放化疗组与单纯放疗组总有效率分别为85.7%和57.1%,两组差异有统计学意义。同步放化疗组1、2、3年生存率为66.7%、33.3%、23.8%,单纯放疗组1、2、3年生存率为38.1%、14.3%、9.5%,两组差异有统计学意义(P<0.05)。两组的不良反应除骨髓抑制和消化道反应外无显著性差异。结论GP方案同步放疗治疗Ⅲ期非小细胞肺癌患者耐受性良好,疗效满意,远期疗效有待进一步观察。更多还原

【Abstract】 Objective To evaluate the clinical efficacy and tolerance of Gecitabine plus cisplatin (GP) concomitant radiotherapy in patients with stage Ⅲ non-small cell lung cancer. Method From January 2002 to January 2004,42 patients with stage Ⅲ non-small cell lung cancer were randomly and equally divided into two groups: radiotherapy group and concomitant chemoradiotherapy group. Patients in the radiotherapy group were initially treated with a conventional dose of 40 Gy,then followed by modulated radiotherapy (MRT) at 25～30 Gy/10～12 times with the total dose of 65～70 Gy. Patients in the chemoradiotherapy group were treated with 4 to 6 cycles of concomitant radiotherapy and chemotherapy. Each cycle (21 days) of the treatment consisted of an intravenous injection of Gecitabine (1g/m2 at d1 and d8) and cisplatin (30 mg/m2 from d1 to d3). Result The overall response rate (CR+ PR) in concomitant chemoradiotherapy group and radiotherapy group was 85.7% and 57.1%,respectively (P<0.05). The 1,2 and 3-year survival rate was 66.7%,33.3% and 23.8% for the concomitant chemoradiotherapy group and 38.1%,14.3% and 9.5% for the radiotherapy group,respectively (P<0.05). With the exception of myelosuppression and digestive reaction,the difference in the toxicity was not significant (P >0.05). Conclusion Concomitant radiotherapy with Gecitabine plus cisplatin can significantly improve the response rate in patients with stage Ⅲ non-small cell lung cancer and the toxicity is well tolerated. However,monitoring of the long-term survival is required.更多还原