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目的 :探讨Ⅲb期非小细胞肺癌 (NSCLC)局部小野放疗与长春瑞滨加顺铂联合化疗 (NP方案 )同步进行的临床疗效、生存质量和毒副反应。方法 :1996年 6月～ 1999年 3月 ,2 3例Ⅲb期NSCLC患者行同步放、化疗。化疗方案 :长春瑞滨 (NVB) 2 5mg/M2d1,d8;顺铂 (DDP) 30mg/M 2d1- 3,2 8天为一周期。放疗采用针对局部病变小野放疗 ,后程加速超分割方式 ,总剂量达 6 1～ 70Gy。结果 :全组病例总有效率达 86 96 % ,中位生存期 (MST) 16个月 ,1、3、5年生存率分别为 6 5 2 2 %、30 4 3%、4 35 %。骨髓抑制是主要的限制性毒副作用 ,放疗前后检测肺功能无明显改变。结论 :NP方案联合化疗加同期局部小野放疗治疗Ⅲb期NSCLC可提高疗效 ,延长中位生存期而不降低生存质量。
Objective: To investigate the clinical efficacy, quality of life and adverse reactions of Ⅲb non-small cell lung cancer (NSCLC) local genital radiotherapy and vinorelbine combined with cisplatin combined with chemotherapy (NP regimen). Methods: From June 1996 to March 1999, 23 patients with stage Ⅲb NSCLC underwent concurrent radiotherapy and chemotherapy. Chemotherapy regimens: vinorelbine (NVB) 25mg / M2d1, d8; cisplatin (DDP) 30mg / M 2d1-3, 28 days for a cycle. Radiotherapy for the local lesion Ono radiotherapy, after the accelerated hyperfractionation method, a total dose of 6 1 ~ 70Gy. Results: The total effective rate was 86 96%. The median survival time (MST) was 16 months. The 1, 3, 5 year survival rates were 65.2%, 30.43% and 4.35% respectively. Myelosuppression is the main limiting toxic and side effects, no significant change in pulmonary function test before and after radiotherapy. CONCLUSIONS: NP regimen combined with chemotherapy plus local-field radiation therapy for stage Ⅲb NSCLC can improve the efficacy, prolong the median survival without reducing the quality of life.