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目的探讨常规剂量多疗程同步放化疗治疗晚期非小细胞肺癌的疗效和不良反应。方法184例Ⅲ期非小细胞肺癌患者随机分为3组,放疗组61例,采用常规放疗为前后野照射,40GY后缩野加量,肿瘤灶总剂量60GY。有淋巴结转移者照射60GY;化疗组60例,采用紫杉醇联合顺铂常规剂量化疗6周期,28天为1周期;同步放化疗组63例,化疗开始的第8天进行放疗,方法同上两组,直至疗程结束。结果同步放化疗组、放疗组、化疗组有效率分别为76.2%、62.3%、56.7%,化疗组与同步放化疗组比较差异有统计学意义(χ2=5.27,P=0.021),放疗组与同步放化疗组比较差异无统计学意义(χ2=2.82,P=0.094)。同步放化疗组、放疗组、化疗组的1、2、3年生存率分别为68.2%、43.3%、19.0%,51.5%、20.5%、7.8%,54.0%、28.8%、10.1%,中位生存期分别为18、12、13个月。化疗组、放疗组与同步放化疗组比较差异有统计学意义(χ2=6.26,P=0.039)。同步放化疗组不良反应比较大,但可以耐受。结论常规剂量6周期紫杉醇联合顺铂同步放化疗,能明显提高晚期非小细胞肺癌患者的有效率和生存率,不良反应有所加重,但不影响治疗的正常进行。
Objective To investigate the curative effect and adverse reactions of conventional dose and multiple courses of concurrent chemoradiotherapy in the treatment of advanced non-small cell lung cancer. Methods A total of 184 patients with stage Ⅲ non-small cell lung cancer were randomly divided into three groups. The radiotherapy group consisted of 61 patients. Radiotherapy was performed in both anteroposterior and auricular fields with conventional radiotherapy. The total amount of tumor was 60 Gy. 60GY in patients with lymph node metastasis; 60 patients in chemotherapy group, the conventional chemotherapy with paclitaxel plus cisplatin 6 cycles, 28 days for 1 cycle; concurrent chemoradiotherapy 63 patients, the first 8 days of chemotherapy for radiotherapy, the same way as the two groups, Until the end of treatment. Results The effective rates of concurrent chemoradiotherapy, radiotherapy and chemotherapy were 76.2%, 62.3% and 56.7% respectively. There was significant difference between chemoradiotherapy and concurrent chemoradiotherapy (χ2 = 5.27, P = 0.021) There was no significant difference in concurrent chemoradiation (χ2 = 2.82, P = 0.094). The 1, 2, 3-year survival rates of concurrent chemoradiation, radiotherapy and chemotherapy groups were 68.2%, 43.3%, 19.0%, 51.5%, 20.5%, 7.8%, 54.0%, 28.8% and 10.1% Survival were 18,12,13 months. Chemotherapy group, radiotherapy group and concurrent radiotherapy and chemotherapy group, the difference was statistically significant (χ2 = 6.26, P = 0.039). Adverse reactions of concurrent chemoradiotherapy group is relatively large, but can be tolerated. Conclusion Conventional radiotherapy with 6-week paclitaxel plus cisplatin can significantly improve the efficiency and survival rate of patients with advanced non-small cell lung cancer. Adverse reactions are aggravated, but do not affect the normal treatment.