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目的:观察三维适形放疗联合紫杉醇/顺铂方案治疗Ⅳ期非小细胞肺癌(NSCLC)的近期疗效和毒副作用,探讨放疗在Ⅳ期非小细胞肺癌中的应用价值。方法:29例Ⅳ期非小细胞肺癌患者,化疗采用TP方案,紫杉醇135mg/m2,静滴,d1;顺铂40mg/d,静滴,d1-3,,21天为1周期,采用三维适形放疗,常规分割1.8~2.0 Gy/次,1次/d,总剂量50Gy~65Gy/5周~6.5周。结果:29例Ⅳ期NSCLC患者治疗后,中位疾病无进展时间9.0个月,其中CR 3例(10.3%),PR10例(34.5%),SD 9例(31.0%),有效率(CR+PR)为44.8%,临床受益率(CR+PR+SD)75.9%,主要的毒副反应为血液学毒性、胃肠道反应以及放射性肺炎、放射性食管炎等,Ⅱ度以上放射性肺炎的发生率为41.4%,Ⅱ度以上放射性食管炎的发生率为34.5%。结论:三维适形放疗联合TP方案化疗治疗Ⅳ期非小细胞肺癌的近期疗效较为满意,毒副反应可以耐受,值得进一步临床研究。
Objective: To observe the short-term curative effect and side effects of three-dimensional conformal radiotherapy combined with paclitaxel / cisplatin regimen in the treatment of stage Ⅳ non-small cell lung cancer (NSCLC) and explore the value of radiotherapy in stage Ⅳ non-small cell lung cancer. Methods: Twenty-nine patients with stage Ⅳ non-small cell lung cancer were treated with TP regimen. Paclitaxel 135 mg / m2, intravenous infusion, d1; cisplatin 40 mg / d, intravenous infusion, d1-3, Radiotherapy, conventional segmentation 1.8 ~ 2.0 Gy / times, 1 / d, the total dose of 50Gy ~ 65Gy / 5 weeks to 6.5 weeks. Results: The progression-free duration of median disease was 9.0 months after treatment in 29 patients with stage Ⅳ NSCLC. There were 3 patients (10.3%) in CR, 10 patients (34.5%) in CR, 9 patients (31.0%) in SD, PR) was 44.8%. The clinical benefit rate (CR + PR + SD) was 75.9%. The main toxicities were hematological toxicity, gastrointestinal reactions, radiation pneumonitis and radiation esophagitis. Was 41.4%. The incidence of radiation esophagitis with Ⅱ degree was 34.5%. Conclusion: The short-term curative effect of 3D conformal radiotherapy combined with TP regimen chemotherapy for stage IV non-small cell lung cancer is satisfactory, and the toxic side effects can be tolerated. It is worth further clinical study.