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目的探讨同步放化疗后序贯化疗治疗局部进展期肺癌的疗效和安全性。方法 60例局部进展期肺癌患者,随机分为A组和B组,各30例。A组接受同步放化疗后序贯化疗,B组则采用序贯放化疗。比较两组的近期疗效和远期疗效及不良反应发生情况。结果 A组总有效率63.3%,明显高于B组的40.0%,差异有统计学意义(P<0.05)。A、B组的中位生存时间分别为18.2个月、12.4个月。A组1年生存率为66.7%,3年生存率为20.0%,明显高于B组的46.7%、6.7%,差异有统计学意义(P<0.05);A组白细胞减少达Ⅲ、Ⅳ级的比例明显低于B组(P<0.05),两组放射性肺损伤、放射性食管炎发生率比较差异无统计学意义(P>0.05)。结论对局部进展期肺癌患者,同步放化疗后序贯治疗能一定程度提高治疗效果,提高患者的近期疗效及远期疗效,且减轻骨髓抑制作用,值得临床借鉴。
Objective To investigate the efficacy and safety of sequential chemotherapy after concurrent chemoradiotherapy for locally advanced lung cancer. Methods Sixty patients with locally advanced lung cancer were randomly divided into group A and group B, with 30 cases in each group. Group A received sequential chemoradiotherapy after chemotherapy, while group B received sequential chemoradiation. The two groups were compared the short-term efficacy and long-term efficacy and adverse reactions. Results The total effective rate in group A was 63.3%, which was significantly higher than that in group B (40.0%), the difference was statistically significant (P <0.05). The median survival time in groups A and B were 18.2 months and 12.4 months respectively. The 1-year survival rate was 66.7% in group A and 20.0% in 3-year group, which was significantly higher than 46.7% and 6.7% in group B (P <0.05). The leukopenia in group A was Ⅲ and Ⅳ (P <0.05). There was no significant difference in the incidence of radiation-induced lung injury and radiation esophagitis between the two groups (P> 0.05). Conclusions For patients with locally advanced lung cancer, sequential therapy after concurrent chemoradiotherapy can improve the therapeutic effect to a certain extent, improve the short-term and long-term efficacy of the patients and reduce the myelosuppression, which is worthy of clinical reference.