摘要
背景与目的：临床约2／3的Ⅲ期非小细胞肺癌患者确诊时已失去手术机会，单纯放疗或化疗疗效均不理想，5年生存率只有5％～10％。同步放化疗的不同治疗方法问有协同作用，可获得更好的局部控制率和生存率，有报道5年生存率为15．8％。但其毒副反应较大。本研究前瞻性比较两种同步放化疗方案治疗不能手术的Ⅲ期非小细胞肺癌的疗效及毒副反应，以期取得较佳疗效的同时，降低毒副作用。方法：48例不能手术的Ⅲ期非小细胞肺癌患者，随机分成两组，紫杉醇每周小剂量组（每周小剂量组）和3周紫杉醇＋顺铂（DDP）常规剂量组（对照组）。两组的放疗方法相同，均采用常规分割放疗。每次2．0Gy，每周5次，原发肿瘤灶总剂量60～64Gy。每周小剂量组在放疗同时给予紫杉醇每周45mg／m^2，连用6周；对照组给予紫杉醇135mg／m^2，第1、22天＋DDP 50mg／m^2第2～4天，第23～25天。结果：每周小剂量组和对照组的有效（CR＋PR）率分别为79％和75％（P〉0．05），而两组CR率分别21％和13％（P〈0．05）。1、2、3和5年生存率分别为83％、63％、38％、13％和63％、42％、17％、8％，差异接近显著性意义。紫杉醇每周小剂量组重度毒副反应小，但两组问差异无显著性意义（P〉0．05）。结论：紫杉醇每周小剂量同步放化疗方案组可降低毒副反应，并有望延长生存时间。
Background and purpose： The curative effect with radiotherapy or chemotherapy alone for the patients with unresectable stage Ⅲ non-small-cell lung cancer was poor. The 5-year survival was only 5-10 percent. Concurrent chemoradiotherapy could achieve better local control and overall survival of those patients and it had been reported that the 5-year survival was improved to 15.8 percent, but the toxicity were much more severe at the same time. We prospectively evaluated the efficacy and toxicity of concurrent chemoradiotherapy with low dose weekly paclitaxel for unresectable stage Ⅲ non-small-cell lung cancer and tried to make the regime more tolerable without the deterioration of treatment response. Methods： Forty-eight patients with unresectable stage Ⅲ non-small-cell lung cancer were randomized into low dose weekly paclitaxel group and control group. Both groups were treated by the standard fractionation schedule. All patients were irradiated 2.0Gy/per fraction, five fractions a week, the total radiation dose was 60-64 Gy for tumor. Patients in the low dose weekly paclitaxel group received chemotherapy with 45 mg/m^2 of paclitaxel on every Monday; the patients in control group received 50 mg/m^2 of cisplatin on days 2-4 and day 23-25, and 135 mg/m^2 of paclitaxel on days 1 and 22 concomitant with the radiotherapy. Results： The CR （complete response） rates of low dose weekly paclitaxel and control group were 21% and 13% respectively （P 〈 0.05）. Median time for local tumor control in low dose weekly paclitaxel group was longer than in control group （P = 0.049 3）. Survival rate of low dose weekly paclitaxel group was higher than control group （P = 0.053 2）. The difference in terms of toxicities was not statistically significant between the two groups （P 〉 0.05）. Conclusions： The patients treated by low-dose weekly paclitaxel group showed that both survival fraction and the period of local tumor control were higher than in control group. Additionally, low dose weekly paclitaxel concomitant with radiotherapy was well tolerated and were not statistically different from control group in terms of toxicities.
出处
《中国癌症杂志》
CAS
CSCD
2006年第4期277-280,共4页
China Oncology
关键词
非小细胞肺癌
同步放化疗
疗效
non-small-cell lung cancer
concurrent chemoradiotherapy
efficacy
作者简介
通讯作者：林贵山 E-mail：lingsh1970@tom．com
