同步放化疗肺癌中文版

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1、ManagementofunresectablestageⅢnon-smallcelllungcancer:theroleofcombinedchemoradiationintroductionUntilthelate1980s,thoracicradiationtherapy(TRT)remainedthestandardcareforlocallyadvancedNSCLC.Radiationalone?Sequentialchemoradiation?CALGB8433RT60GyPV2cycles＋RT60

2、GyNo.7779MST9.713.81-yearsurvival40552yearsurvival13263yearsurvival11235yearsurvival719Pvalue0.0066DillmanRO,NEJM323:940-945,1990DillmanRO,JNCI88:1210-1215,1996RTOG8808RT60GyCT+RTH-RT69.6GyNo152152154MST11.413.2121-yearsurvival4759522-yearsurvival2132243-yearsu

3、rvival1117145-yearsurvival6119Pvalue0.04SauseW,JNCI1995;87:198-205SauseW,CHEST2000;117:358-364OSConcurrentchemoradiation?Radiationalone?EORTCRT55PDD(W)+RTPDD(D)+RTNo3113113111-ysurvival4644542-ysurvival1319263-ysurvival21316Pvalue0.0091-yLCR193031Pvalue0.003Sch

4、aake-KoningC,NEJM1992;326:524-530IntensifiedregimenH-RTH-RT/CTH-RT/CTNo615256methods64.8Gy64.8/CE64.8/CEMST818133-ysurvival6.62316JeremicB,JCO1995;13:452-458LeeJS,JCO1994;14:1055-1064CT:weekly,100mg/m2CBPD1,D2;100mg/m2VP-16D1-3CT:200mg/m2CBPD1,D2;100mg/m2VP-16D

5、1-5,thefirst,third,andfifthweeksMetaAnalysisResults(52trials,9387pts)2-yearsurvival4%。Hazardratio:0.87。NSCLCCG,BMJ1995;311:899-909Concurrentchemoradiation?Sequentialchemoradiation?concurrentsequentialPvalueNo156158methods56Gy/MVP2CMVP2C+56MST16.513.30.042-ysu

6、rvival34.627.43-ysurvival22.314.74-ysurvival16.910.15-ysurvival15.88.9ResponseR84660.0002FuruseK,JCO1999;17:2692-2699JapanRTOG9410sequentialconcurrentconcurrent+HFNo(total)611RT606069.6methodsPV2CPV2CPEMST14.61715.6A-Toxicity304862L-Toxicity141516CurranWJ,PASCO

7、2000;19:484aACR427(phaseⅡ)seqCon(ind/con)Con(con/adi)No(total)276RT636363CTPC2PC2+CONCON+PC2MST12.51116.1Esophogitis(≥3）42028ChoyH,PASCO2002;abstract:1160GLOT9501SEQCONNo(total)212RT66Gy66CTNP3CindCE+CE2Cadi3/4neutropenia87.8753/4oesophagitis026.1MST13.915.61-y

8、survival56562-ysurvival2335PierreF,PASCO2001;abstract:1246MSTOSE-toxicitySCSCSCfuruse13.316.5916(5)423RTOG14.617.11221(4)425GLOT13.915.62435(2)317Czech13.220.61542(2)428BROC