摘要
目的回顾分析NP方案联合适形放疗治疗晚期非小细胞肺癌的临床疗效和毒副作用。方法32例Ⅲ期和Ⅳ期非小细胞肺癌患者,均行夹心序贯法NP方案化疗联合适形放疗。NP方案为诺维本25mg/m^2,d1,d8;DDP25mg/m^2,d1-3,21天为1周期。化疗两周期后行三维适形常规分割放疗,之后再化疗。放射源为直线加速器X线,15MV,照射剂量为36-66Gy。锁骨上区预防照射,8M eV电子线,20-30Gy。结果夹心序贯法化疗联合放疗总有效率（RR）50.0%,其中1例达到完全缓解。ⅢA、ⅢB和Ⅳ期患者有效率（RR）分别为80.0%,57.1%和30.8%。鳞癌、腺癌患者有效率分别为63.6%、22.2%。疾病控制率（DCR）为90.6%（29/32）。中位疾病进展时间（TTP）为178天（60-446天）。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和缓解。结论NP方案化疗联合放疗对晚期非小细胞肺癌有较好的近期疗效和疾病控制率,毒副反应能够被患者耐受。
Objective To analyze retrospectively the clinical effects and side effects of combination of NP chemotherapy with conformal radiotherapy in treating advanced stage non-small cell lung（NSCLC） cancer. Methods 32 patients of stage Ⅲ and Ⅳ non-small cell lung cancer were treated with sequeutial NP chemotherapy and radiotherapy, followed by NP chemotherapy again. The NP regimen included Navelbine （25mg/m^2, dl, d8） and DDP （25mg/m^2, dl-3）, repeated every 21 days. Conventional fractionation 3-dimentional con- formal radiotherapy was performed using 15MV x-rays after 2 cycles of chemotherapy, with total dose of 36 to 66 Gy. Then, two more cycles of chemotherapy was performed. Prophylactic supraclavicular irradiation was delivered using 8MeV Electron Beam with total dose of 20 to 30Gy. Results Combination of chemo with radiotherapy has shown an overall response rate of 50.0%, with 1 patient achieved complete responses. The response rate （RR） of stage ⅢA, ⅢB and Ⅳ was 80.0% 57.1% and 30.8% respectively. Patients with squamous and adenocamomal NSCLC achieved 63.6% and 22.2% RR respectively. The disease control rate （DCR） was 90.6% （29/32）,medium time to progression （TIP） was 178 days （60-446d）. Major side effects included bone marrow suppression, gastrointestinal reaction, radiation pneumonitis and radiation esophagitis, all of which could be relieved by corresponding measurements. Conclusion The combination of NP chemotherapy with conformal radiotherapy has good therapuntics effect and DCR in NSCLC patients with acceptable toxicity.
出处
《咸宁学院学报（医学版）》
2008年第1期23-26,共4页
Journal of Xianning Univarsity(medical Sciences)
关键词
非小细胞肺癌
化疗
放疗
Non-small cell lung cancer
Chemotherapy
Radiotherapy
