放化疗同步治疗Ⅲ期非小细胞肺癌【医学论文开题报告，精】.doc

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1、临床医学论文■放化疗同步治疗ni期非小细胞肺癌作者：杨志诚何永萍唐志杨志雄黄杰【关键词】放化摘要：冃的：评价放射治疗合不同化疗方案的治疗不能手术的山期非小细胞肺癌（NSCLC）疗效。方法：62例不能手术的山期NSCLC患者随机分为2个组；29例化疗组每周接受1次紫杉醇30mg，顺钳30mg化疗（紫杉醇组），33例为对照组。连续5〜6周，均同时配合常规分割放射冶疗（2Gy/次、5次/周），照射野包括肺部原发灶和纵隔淋巴引流区，总剂里为60〜70Gy。结果：紫杉醇组总有效率（CR+PR）为82.8%，完全缓解（CR）率为10.3%,对照组总有效率为54.6%,CR率为

2、18.0%°2个组总有效率差异有显著性意义（X2二4.41p=0.038）。中位生存期1、2年生存率紫杉醇组分别为12.8个月，52.2%、27.3%，对照组分别为9.8个月、42.8%、18.4%，2个组差异无显著性意义。化疗的毒副作用主要是骨髓抑制和消化道反应，但均可耐受。结论：紫杉醇组绐疗不能手术的3期NSCLC近期有效率明显优于单放组，但不捉高生存率。关键词：非小细胞肺癌/放射疗法；非小细胞肺癌/药物疗法；综合治疗ConcomitantChemotherapyandRadiotherapyforInoperableStage3Non・smdllCel1Lu

3、ngCancerAbstract:Objective:Toevaluatetheeffectofconcomitantdifferentregimenschemotherapyandradiotherapyforinoperablestage3non-smal1ccl1lungcancr(NSCLC),MethodsFronSeptember1998toDecember2000,62patientswinthinoperablestage3NSCLCwererandomizedintogroups・Method:Ninepatientsreceivedpaclit

4、axel30mgandcisplain30mgweeklyfor5〜6weeks(paditaxelgroup),and33patientswascontrolgroup.Al1patientsreceivedconcomilanlradiotherapyaswcl1.Radiotherapywasgivenwitheonventionalfractionin2Gyperfractionandfivefractionsperweek.Thetotaltumordoseswere60〜70Gy・Treatmentfieldscoveredclinicalumoran

5、dlymphnodeinvlolvcd.Result:Theovcral1response(CR+PR)rateinpaclitaxelgroupwas82.%withacopleleresponse(CR)rateof10.3%.Theoveral1responserateinthecontrolgroupwas54.6%withaCRrateof18%.Thedifferenceofoveral1responseratebetweenthetwogroupswasstatisticallysignificant(Pv0・05)themediansurvival

6、timeand2・yearsurvivalrateswere12.8monthc,52・2%and27.2%forpaclitaxelgroup,and9.8months,42.8%and18.4%forthecontrolgroup(P>0.05).themajortoxiceffectsofchemotherapyweregastrointestinaltractreactincandmyelosuppression.Conclusion：Concomitantchemotherapyofpaditaxelpluscisplatinandradiotherap

7、yforinoperablestage3NSCLCisacceptable,anditsefficacyissuperiortoradiotherapyalone.Keywords:Non-smal1cel11ungcarcinoma/radiotherapy;Non-sam11cel1lungcarcinoma/drugtherapy;Combincdmodalitytherapy非小细胞肺癌(non-saml1ccl1lungcarcinoma,NSCLC)约占肺癌总数的80%〔1〕，就诊时绝大多数患者已失去手术机会，可选择放射治疗或化疗，由于NSCLC对放射

8、治疗和化疗