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目的:评价NP方案放化同步治疗局部晚期(Ⅲa,Ⅲb期)非小细胞肺癌(NSCLC)的临床近期疗效及毒副反应。方法:28例晚期NSCLC患者同时接受NP方案化疗及肺内原发灶和区域淋巴结X线放疗,每次放疗剂量为2.0GY,每周5次,总剂量60GY。放疗与化疗同一天开始,NVB(盖诺)25mg/m2,DDP30mg/m2,第1天,第8天,第29天,第36天给药,放疗结束3周后,常规给予NP方案全身化疗2个周期。NVB25mg/m2~30mg/m2,第1天,第8天,DDP75mg/m2,分3d给药,21d~28d1个周期。结果:同步放化疗联合全身化疗的有效率为75%(21/28),其中完全缓解(CR)4例14.3%,部分缓解(PR)17例60.7%。毒副反应以可逆性骨髓抑制、消化道反应、放射性食管炎为主。其中白细胞减少发生率为96.4%(27/28),Ⅲ°~Ⅳ°骨髓抑制发生率35.7%(10/28),消化道反应、放射性食道炎症状轻微,给予预防和对症治疗可缓解。结论:NP方案放化同步治疗是综合治疗局部晚期NSCLC的安全有效的手段,值得进一步临床研究。
OBJECTIVE: To evaluate the short-term clinical efficacy and side effects of radiotherapy and concurrently NP regimen in the treatment of locally advanced non-small cell lung cancer (NSCLC) with stage Ⅲa and Ⅲb. Methods: Twenty-eight patients with advanced NSCLC received NP chemotherapy and primary lung cancer and regional lymph node radiotherapy at a dose of 2.0 Gy per treatment, with a total dose of 60 Gy per week. Radiotherapy and chemotherapy started on the same day, NVB 25mg / m2, DDP30mg / m2, on the first day, on the 8th day, on the 29th day, on the 36th day, 3 weeks after the end of radiotherapy, 2 cycles. NVB25mg / m2 ~ 30mg / m2, on the first day, on the eighth day, DDP75mg / m2, sub-3d administration, 21d ~ 28d1 cycle. Results: The effective rate of concurrent chemoradiotherapy combined with systemic chemotherapy was 75% (21/28), including 14.3% of complete remission (CR) and 17 cases of 60.7% of partial remission (PR). Toxicity to reversible myelosuppression, gastrointestinal reactions, radiation-based esophagitis. The incidence of leukopenia was 96.4% (27/28), and the incidence of bone marrow suppression was 35.7% (10/28) in Ⅲ ° ~ Ⅳ °. The symptoms of gastrointestinal tract reaction and radiation esophagitis were mild. Preventive and symptomatic treatment were relieved. Conclusion: The synchronized radiotherapy and radiotherapy of NP is a safe and effective method for the comprehensive treatment of locally advanced NSCLC, which deserves further clinical study.