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目的观察中晚期非小细胞肺癌(NSCLC)患者同步化疗(CT)及三维适形放射治疗(3DCRT),加用痰热清注射液能否减轻治疗的肺毒性反应。方法观察组(同步CT+3DCRT+痰热清)与常规治疗组(同步CT+3DCRT)各39例。常规组治疗同步用紫杉醇+顺铂/紫杉醇+卡铂(TP/TC)方案化疗及3DCRT放疗,肺V20≤20%。观察组治疗同常规组外,在放疗30 Gy/15 Fx后加用痰热清20 ml/d,静脉滴注至放疗结束。两组在治疗过程中出现肺毒性反应时均加用地塞米松及抗炎和对症支持治疗。结果肺毒性反应总发生率观察组与常规组分别为33.3%和66.7%(P=0.02765),两组肺毒性发生的时间Ⅰ级分别为43.7 d和33.8 d,Ⅱ级分别为45.3 d和38.1 d(P<0.05);发生的剂量Ⅰ级分别是63.5 Gy和49.8 Gy(P<0.05),Ⅱ级分别是66.7 Gy和56.3 Gy(P<0.05)。结论痰热清值得进一步在NSCLC患者同步CT+3DCRT中扩大临床观察研究。
Objective To observe whether simultaneous chemotherapy (CT) and three-dimensional conformal radiotherapy (3DCRT) in patients with advanced non-small cell lung cancer (NSCLC) can reduce the pulmonary toxicity of treatment with the addition of Tanreqing injection. Methods Thirty-nine patients were observed in the observation group (synchronous CT + 3DCRT + Tanreqing) and conventional treatment group (synchronous CT + 3DCRT). The conventional group was treated with paclitaxel + cisplatin/paclitaxel + carboplatin (TP/TC) chemotherapy and 3DCRT radiotherapy. The lung V20 was less than or equal to 20%. The observation group was treated with the same routine group. After 30 Gy/15 Fx of radiotherapy, it was supplemented with Tanreqing 20 ml/d and was infused intravenously until the end of radiotherapy. Dexamethasone plus anti-inflammatory and symptomatic supportive therapy were added to both groups during the course of pulmonary toxicity. Results The total incidence of pulmonary toxicity was 33.3% in the observation group and 66.7% in the conventional group (P=0.02765). The time of occurrence of lung toxicity in the two groups was 43.7 d and 33.8 d, respectively, and the grade II was 45.3 d and 38.1 respectively. d (P<0.05); the dose level I occurred was 63.5 Gy and 49.8 Gy (P<0.05), and the level II was 66.7 Gy and 56.3 Gy (P<0.05). Conclusion Tanreqing is worth further expanding the clinical observation of synchronous CT+3DCRT in patients with NSCLC.