摘要
目的 评价紫杉醇和放疗同步与序贯治疗局部晚期NSCLC的疗效、毒性反应 ,并探讨其效应机理。方法 将 36例局部晚期或复发的NSCLC患者随机分为两组 ,同步组为每周紫杉醇 40mg/m2 连用 6周 ,同时行区域淋巴结和原发病灶前后野照射 40Gy ,病灶区再追加 2 0～ 2 5Gy外照射 ,外照射总剂量约 60～65Gy。序贯组为先行紫杉醇 175mg/m2 加顺铂 10 0mg/m2 化疗两周期后再行放疗。结果 同步组有效率为66.7% ,序贯组为 5 0 %。对放疗区域局控率同步组有效率为 83.3% ,序贯组为 5 0 % ,同步组中位生存期为 12个月 ,序贯组为 11个月。同步组主要毒性为食管炎 ,发生率为 72 .2 % ,序贯组 33.3% ,其他毒性反应均较轻。而序贯组主要毒性表现为白细胞减少 ( 94.4% )、恶心呕吐 ( 94.4% )、脱发 ( 94.4% )、神经毒性 ( 77.78% )和肾毒性 ( 2 7.78% )。结论 每周紫杉醇放射增敏与序贯治疗局部晚期NSCLC均显示较好的疗效 ,值得进一步扩大临床研究。同步治疗除食管炎发生率高外 ,其他毒性反应均较低 ,患者能够耐受。
Abjective To evaluate the results of taxol and concomitant radiotherapy and those of sequential combined modality chemotherapy with taxol plus cisplatin (DDP) and radiotherapy in treatment of locally advanced non small cell lung cancer (NSCLC). Methods From January 1998 through August 1999, 36 patients (24 male, 12 female; 18 squamous cell carcinoma, 14 adenocarcinoma, 4 others; 24 initially treated, 12 retreated) with locally advanced NSCLC were enrolled in this study and were randomized into 2 groups. The median age of the patients was 58. The majority of patients had a performance status of 0 or 1. In concomitant group, the patients received radiation therapy at 2?Gy given on Monday to Friday of each week for 6 to 7 consecutive weeks. The total planned radiation dose was 60 to 65 Gy. At twenty-four hours before radiotherapy, taxol 40?mg/m 2 was administered on Sunday of each week for 6 consecutive weeks. In sequential group, the patients received induction chemotherapy with taxol 175?mg/m 2 and cisplatin 100mg/m 2 every 3 weeks for two cycles followed by conventional radiation therapy. Results The overall response rate was 66.7%(12/18) in concomitant group and 50%(9/18) in sequential group. The local control rate was 83.3%(15/18) in concomitant group and 50% (9/18) in sequential group. The main toxicity in concomitant group was esophagitis (72.2%,13/18). The hematological toxicity and other nonhematological toxicity were mild in concomitant group. The main toxicities in sequential group were leukocytopenia (94.4%,17/18; grade 3/4 in 7 patients), nausea and vomiting (94.4%, 17/18; grade 3/4 in 5 patients), alopecia (grade 3/4 in 8 patients), neurotoxicity (grade 1/2 in 14 patients) and nephrotoxicity (grade 1/2 in 5 patients). One year survival rate in concomitant group was 50% (9/18) and in sequential group was 44.4% (8/18). The median survival period was 12 months in concomitant group and 11 months in sequential group. Conclusion Weekly taxol and concomitant radiotherapy is as effective as sequential combined modality in patients with locally advanced NSCLC and concomitant chemoradiotherapy has higher local control rate and lower toxicity except for esophagitis.
出处
《中国肺癌杂志》
CAS
2001年第4期268-271,共4页
Chinese Journal of Lung Cancer
关键词
非小细胞肺癌
放疗
化疗
紫杉醇
治疗
Non-small cell lung cancer Radiotherapy Chemotherapy Taxol
