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目的 评价放化疗同步与放化序贯 2种方法治疗Ⅲ期非小细胞肺癌 (NSCLC)的疗效及毒副反应。方法 对 6 0例ⅢA/ⅢB期NSCLC患者随机分成放化疗同时进行组 (治疗组 )和放化疗序贯进行组 (对照组 )。治疗组放疗采用超分割方法 ,每次 1 2Gy,2次 /天 ,间隔 4～ 6h ,5天 /周 ,总剂量为 6 9 6Gy。化疗采用卡铂 10 0mg +VP - 16 10 0mg ,每周 1次 ,共 5～ 6周。对照组放疗采用常规放射治疗方法 ,每次 2Gy ,每天 1次 ,每周 5天 ,共 6周 ,总剂量为 6 0Gy ,化疗於放疗前和 (或 )放疗后 1个月进行 ,采用MVP方案 (MMC10mg第 1天 ,VDS3mg/m2 第 1～ 3天 ,DDP30mg/m2 第 1～ 3天 ) 2周期。结果 治疗组总有效率为 72 4 % ,对照组总有效率为 6 3 3% ( 19/30 ) ,其中CR 6 7% ( 2例 ) ,PR 5 6 7% ( 17例 ) ,治疗组与对照组总有效率比较无显著性差异 (P >0 0 5 )。治疗组患者放射性食管炎、骨髓抑制、及胃肠反应发生率分别为 79 3% ( 2 3/2 9)、72 4 % ( 2 1/2 9)、75 9% ( 2 2 /2 9) ,均高于对照组的 30 0 % ( 9/30 )、4 6 7% ( 14 /30 )、33 3% ( 10 /30 ) ,均有显著性差异 (P <0 0 1、P <0 0 5、P <0 0 5。)治疗组中位生存期显著高于对照组。结论 超分割放疗结合同期化疗治疗ⅢA/ⅢB期非小细胞肺癌安全有效
Objective To evaluate the efficacy and side effects of two chemotherapeutic chemoradiation and sequential radiosurgery in the treatment of stage Ⅲ non-small cell lung cancer (NSCLC). Methods Sixty patients with stage ⅢA / ⅢB NSCLC were randomly divided into radiotherapy and chemotherapy group (treatment group) and radiotherapy and chemotherapy group (control group). Radiotherapy in the treatment group using super-segmentation method, each 1 2Gy, 2 times / day, interval 4 ~ 6h, 5 days / week, a total dose of 6 9 6Gy. Chemotherapy with carboplatin 10 0mg + VP - 16 10 0mg, once a week for a total of 5 to 6 weeks. The control group radiotherapy using conventional radiotherapy methods, each 2Gy, once daily, 5 days a week for a total of 6 weeks, the total dose of 60Gy, chemotherapy before radiotherapy and (or) 1 month after radiotherapy, using MVP program (MMC10mg on day 1, VDS3mg / m2 on days 1-3, DDP30mg / m2 on days 1-3) 2 cycles. Results The total effective rate was 72.4% in the treatment group and 63.3% (19/30) in the control group, of which CR 6 7% (2 cases) and PR 5 6 7% (17 cases) The total effective rate in the control group showed no significant difference (P> 0.05). The incidences of esophagitis, myelosuppression and gastrointestinal reactions in the treatment group were 79 3% (2 3/2 9), 72 4% (2 1/2 9), 75 9% (2 2/29) , Which were significantly higher than those in the control group (30.0%, 4.6%, 33.3%, 10/30 respectively) (P <0.01, P <0 0 5, P <0 0 5.) The median survival time was significantly higher in the treatment group than in the control group. Conclusion Hyperfraction radiotherapy combined with concurrent chemotherapy is safe and effective in the treatment of stage ⅢA / ⅢB non-small cell lung cancer