局部晚期非小细胞肺癌行三维适形放疗加np方案同期化疗

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1、局部晚期非小细胞肺癌行三维适形放疗加NP方案同期化疗作者：赵洪瑜，施健，王燕，仇晓军，马剑波，汤乐民，周晓曦，朱一真，周士忠，季斌【摘要】目的：评价三维适形放射治疗(3D-CRT)加同期化疗（NP方案）治疗局部晚期非小细胞肺癌（NSCLC）的临床疗效和并发症。方法：12例患者作为观察组：诱导化疗：长春瑞滨（NVB）25mg/m2加入生理盐水(NS)100ml，快速静脉滴注，d1，d5；顺铂（DDP）80mg/m2，静脉滴注。28天1周期，连续2周期。同期化疗：放疗开始后：NVB25mg/m2加NS100ml静脉滴注；

2、DDP25mg/m2加NS500ml静脉滴注，于放疗的间隙每周给药一次，给药2周，休息2周，直至放疗结束。放射治疗：常规放疗于第2周期诱导化疗结束后开始。每次2Gy，每周5次，TD40Gy/4周。结束后，予以3D-CRT局部加量。每次2Gy，每周5次，TD30~34Gy/3~3.5周。14例患者作为对照组：诱导化疗及常规放射治疗同治疗组。结束后予以常规放射治疗缩野至原发灶及转移的淋巴结，追加26~3011Gy/2.6~3周。序惯化疗：放疗结束后即予以2~4周期的NP方案，剂量及给药方法同诱导化疗，28天为1个给药周期

3、。结果：观察组1、2年观察期末生存率为92%和61%，而对照组为57%和14%，log-rank检验P＜0.05。两组患者均未发生严重放化疗毒副反应。结论：3D-CRT加NP方案同期化疗治疗局部晚期NSCLC可以提高肿瘤的局部控制率，提高疗效。【关键词】非小细胞肺癌；三维适形放射治疗；化学治疗Alooking-forwardstudywiththree-dimensionalconformalradiotherapyplusNPscheme[Abstract]Objective:Toevaluatetheresult

4、sandcomplicationsof3Dconformalradiotherapycombinedwiththechemotherapyforlocaladvancednonesmallcelllungcancer(NCSLC).Method:Twelvepatientsinthestudygroupwerereceivedinductionchemotherapy2cyclesnavelbine(25mg/m2d1、d5)andcisplatin(80mg/m2d1or25mg/m2d1-3)followedby

5、conventionalradiotherapy(2Gy/f,5f/w,totally４0Gy),thenbythree-dimensionalconformalradiotherapyboostedtoTD30to34Gyinconventionalfractionationcompletedin3to3.5weeks.Patientswerereceivedchemotherapynavelbine(25mg/m2d1、d8)andcisplatin(25mg/m2d1、d8)forevery28daysinra

6、diotherapyinterval(SaturdayorSunday).Fourteenpatientsincontrolgroupwerereceivedinductionchemotherapyandconventionalradiotherapywhichwerethesameasinstudygroup,11thenfollowedbyconventionalradiotherapywithshrinkagefieldscoveringtheprimarytumorandmetastaticlymphnod

7、eregionhadboostto26~30Gyin2.6to3weeks.Thepatientshadn'treceivedanychemotherapywhileradiotherapy,buttwotofourcoursessequentialchemotherapyofNPschemewereperformedafterradiotherapywhichwerethesamedosesandmedicationasinductionchemotherapy.Results:The1-yearsurvivali

8、nstudygroupwere92%and2-yearwere61%and57%and14%respectivelyincontrolgrouprespectively(log-rankanalysisP＜0.05).Allpatientshadtoleratedthetoxicandsideeffectsandcompletedtreatme