三维适形放疗（3dcrt）联合tp方案化疗治疗局部晚期非小细胞肺癌的临床观察

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1、医学信息2010年5月第23卷第5期论著三维适形放疗(3DCRT)联合TP方案化疗治疗局部晚期非小细胞肺癌的临床观察李德智文世民袁志【摘要】目的：评价三维适形放疗(3DCRT)联合TP方案化疗治疗局部晚期非小细胞肺癌的毒性和疗效。方法：80例局部晚期期非小细胞肺癌病人随机分成两组，4O例(三维适形放疗组，3DCRT)接受了总剂量为6O～70Gy的三雏适形放疗，另40例(综合组，CMT)给予顺铂(DDP)30rag／m2，静脉滴入，第1～3天；多西他赛(DOC)75mg／m2，静脉滴入，第1天；以28d

2、为1周期，共2周期。同时接受与上组相同剂量的三维适形放疗。按wHO疗效及毒性标准来评价治疗毒性和近期疗效。结果：所有病人都完成了治疗，三维适形放疗组和综合组中1+2级血液毒性分别为1O例和l4例，1+2级胃肠遣毒性反应6例和2O例；1+2级食道反应20例和16例，3级1例；1+2级放射性肺炎分别14例和l1例，3级1例和z例。综合组和3DCRT组完全缓解(CR)分别1O例和5例，部分缓解(PR)28例和Z5例，无变化(NR)2例和8例，肿瘤进展(PD)0例和2例，总有效率9S和75(P

3、年生存率为87．5和69．3(P>0．05)。结论：三堆适形放疗毒性反应不大，近期疗效肯定；三维适形放疗同步TP化疗对晚期非小细胞肺癌的近期疗效有改善，毒性反应也有增加，但可以接受。【关键词】三雏适形放疗；顺铂；多西他赛；非小细胞肺癌、晚期StudyonConcomitantDDPDOCand3DCRTRadiotherapyforLocallyAdvancedNon-smallCellLungCancerLJDe—zhiWENShi—rainNZi[Abstract]Objective：Toeval

4、uatetheclinicaltoxicityandelfectofthree—dimensionaIconformalradiotherapy(3DCRT)andthree—dimensionalconformalradiotherapywithconcurrentDDP，DOCinfusionchemotherapy(CMT)forlocallyadvancednon—smal1eel1lungcancer．Methods：8Opa—tientswereallottedtothisclinicst

5、udy，Therewere40patientsinthe3DCRTgroupand40patientsIntheCMTgroup．40patientsinthe3DCRTgroupreceived3DCRTwithatotaldoseof5O～70Gy．thepatientsintheCMTgroupweregivenchemotherapyasfollow：DDP30rag／m2，day1—3，intravenously；andDOC75mg／m2，day1，intravenously，28days

6、percyclefor2cycles，andreceived3DCRTwithatotaldoseof50~70Gyatthesametime．ToxicitiesandeffectswereevaluatedaccordingtothecriteriaofWHO．Results：ThepatientsintheCMTgroupwithgrade1+2leukocy—topeniaandgastrointestinaltoxicityweresignificantlyincreasedcompared

7、withpatientsinthe3DRTgroup．Pneumoniaandradiation-inducedesoph—agitishadnodifferencebetweenthetwogroups．Theoverallresponserate(CR+PR)was95and75，respectively．The1一yearsurvivalrateis87．5and69．3，respectively．Conclusion：Thetoxicityandeffectofthree—dimensiona

8、1conformalradiotherapy(3DCRT)andthree—dimensionaIconforma1radiotherapycombinedwithconcurrentDDP，DoCinfusionchemotherapy(CMT)foradvancednon—smalleelIJungcanceristolerableandimprovementrateandlongsurvivaltimearetobefurtherobserved．