摘要
目的 通过比较支气管动脉灌注 (BAI)化疗联合放射治疗与全身化疗联合放射治疗局部晚期非小细胞肺癌的疗效 ,探讨其应用价值。方法 1 2 1例Ⅲ期非小细胞肺癌患者随机分为 2个组 :治疗组 5 8例 ,行 2～ 3次BAI后 4～ 7d给予放射治疗 ;对照组 6 3例 ,给予 4～ 6个周期全身化疗 ,在第 1个周期化疗后 3～ 4d开始放射治疗 ,至下 1个周期化疗开始时暂停放射治疗 ,使化疗与放射治疗交替进行。结果 两组近期疗效、远期疗效、中位缓解期和中位生存期相似 ,Ⅲb期患者在治疗中出现较多的远地转移 ,其结果明显影响了治疗组的近期疗效。毒副反应 :化疗主要反应为血液学和消化道反应 ,放射治疗主要是放射性肺、纵隔、食管炎的表现。治疗组反应轻 ,患者耐受良好 ,顺利完成治疗。对照组反应较重 ,有 7例主观或客观上不能耐受治疗 ,2 8例需暂停放射治疗或延长化疗周期。结论 BAI联合放射治疗近期、远期疗效与全身化疗联合放射治疗相似 ,但具有症状缓解快、毒副作用轻、治疗后患者体质状况下降不明显、患者依从性高、治疗周期短、治疗费用低等特点。
Objective To compare the efficacy between bronchial artery infusion (BAI) chemotherapy plus radiation therapy and systemic chemotherapy plus radiation for locally advanced non-small cell lung cancer (NSCLC). Methods One hundred and twenty-one patients with stage III NSCLC were randomized into treatment group(58 cases) and control group (63 cases). In the treatment group, all patients were administered with BAI for 2-3 sessions, followed by irradiation 4-7 days after BAI. In the control group, altogether 4-6 cycles of standard systemic chemotherapy were given. Radiation was delivered alternately between the cycles of chemotherapy. Results The short-term, long-term survival, median response duration and median survival time were similar between the two groups, except patients with stage Ⅲb who had a higher distant metastasis rate in the treatment group. The major side effects of chemotherapy and radiotherapy were hematological, gastrointestinal toxicities, pneumonitis, mediastinitis, and esophagitis, respectively. The side effects were milder, better tolerated and did not influence the regimen schedule in the treatment group, as compared with the control group. Seven patients withdrew from the control group, and in 28 patients, the scheduled chemotherapy and radiation was delayed or canceled. Conclusions Bronchial artery infusion plus radiation is more advantageous over systemic chemotherapy plus radiation in less toxicities, better compliance, shorter treatment courses and more cost-effectiveness.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2004年第2期78-81,共4页
Chinese Journal of Radiation Oncology
