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《适形放疗联合NP化疗与单纯NP化疗治疗晚期非小细胞肺癌临床疗效分析【本科临床医学论文》由会员上传分享,免费在线阅读,更多相关内容在工程资料-天天文库。
1、临床医学论文•适形放疗联合NP化疗与单纯NP化疗治疗晚期非小细胞肺癌临床疗效分析【摘要】目的回顾分析适形放疗联合化疗与单纯NP方案化疗治疗晚期非小细胞肺癌的临床疗效和毒副作用。方法76例ni期和IV期非小细胞肺癌患者资料。单纯化疗组31例,接受单纯NP方案化疗。NP方案为诺维本25mg/m2,dl,d8;DDP25mg/m2,dl3,21d为1周期。放疗联合化疗组45例,接受适形放疗联合NP方案化疗,NP方案化疗两周期后续行三维适形常规分割放疗,之后再行NP方案化疗。放射源为直线加速器X线,15MV,照
2、射剂量36〜66Gy。锁骨上区预防照射,8MeV电子线,20〜30Gy。结果放疗联合化疗组有效率(RR)57.8%,其中3例达到完全缓解,单纯化疗组有效率(RR)32.3%,两组间P<0.05,其差异有统计学意义。放疗联合化疗组中鳞癌RR65.6%,腺癌RR41.7%,PC0.05,其差异有统计学意义;MA、MB和IV期RR分别为83.3%,61・1%和33.3%,P<0.05,三者间差异有统计学意义,IHA期与IV期有效率PV0.01,其差异有统计学意义;初治、复治RR为60.1%、20.0%,P<0
3、.05,其差异有统计学意义。单纯化疗组川鳞癌与腺癌、IHB期匀IV期、初治与复治之间有效率差异无统计学意义。放疗联合化疗组的中位疾病进展时间(TTP)为178d(60〜446d)。单纯化疗组的中位TTP为82d(25〜233d)。放疗联合化疗组的毒副反应较单纯化疗组多一些,重一些,主要毒副反应为骨髓抑制、胃肠道反应、放射性肺炎和放射性食管炎,均可以通过相应措施予以纠正、缓解。结论适形放疗联合NP方案化疗较单纯NP方案化疗对晩期非小细胞肺癌有较好的近期疗效,TTP也较长些,毒副反应能够予以纠正、缓解。【关
4、键词】适形放疗化疗非小细胞哺癌ABSTRACT:ObjectiveToanalyzeretrospectivelytheclinicaleffectsandsideeffectsofconformalradiotherapycombinedwithNPchemotherapyandNPchemotherapyforadvancednonsmallcelllungcancer・Methods76patientswithDIandIVstagenonsmal1cel1lungcancerweregroupe
5、d.Chemotherapygroupconsistedof31patients,treatedwithNPchemotherapy.TheNPregimenincludesNavelbine(25mg/m2,dl,d8)andDDP(25mg/m2,dl3),repeatedevery21days・Radiochemotherapygroupconsistedof45patients,receivingthreedimensionalconformalradiotherapy(3DCRT)combin
6、edwithNPchemotherapy.Conventionalfraction3dimentionalconformalradiotherapywasperformed,using15MVxraysfrom1inearaccelerator,after2cyclesofNPchemotherapy,withtotaldose36to66Gy.Then,twomorecyclesofNPchemotherapywereperformed.Prophylacticsupraclavicularirrad
7、iationwasdelivered,using8MeVElectronBeamwithtotaldoseof20to30Gy・ResultsTheoverallresponserate(RR)was57.8%intheradiochemotherapygroup,with3patientsachievedcompleteresponses,32.3%inthechemotherapygroup,therewasasignificentdifference(P<0.05)betweenRRofthetw
8、ogroups・Intheradiochemotherapygroup,RRwas65.6%inpatientswithsquamouscellcarcinoma,41.7%inpatientswithadenocarcinoma,therewasastatisticaldifference(P<0.05)betweenRRofthetwotypes.RRofthestageDIA,DIBandIVwas83.3%,61.1%and33.3