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目的探讨放化同步治疗中老年非小细胞肺癌(NSCLC)时紫杉醇剂量的选择。方法选择60例NSCLC患者,其中男性36例,女性24例;年龄55~65岁。随机分为A、B、C、D、E 5组,每组12例患者。所有患者先经过3个周期的诱导化学治疗,1个月后进行放化同步治疗。三维适形放射治疗在5~6周内完成,控制总剂量在60 Gy;化学治疗时使用紫杉醇,A组2次/周,每次10mg/m2;B组2次/周,每次15 mg/m2;C组2次/周,每次20 mg/m2;D组3次/周,每次10 mg/m2;E组3次/周,每次15 mg/m2,6周完成治疗。当任何一组患者在治疗期间出现半数以上的患者发生3度以上急性不良反应即停止该组试验。结果 A、B、D 3组出现3度以上不良反应的患者均未超过半数,完成所有治疗,近期总有效率分别为41.67%、75.00%、66.67%;C、E两组因出现3度以上不良反应的患者超过半数而停止试验。结论在诱导化疗后使用放化同步治疗中老年局部晚期NSCLC患者时紫杉醇最佳使用剂量的选择为每周30 mg/m2,可根据患者具体身体状况调整每次给药剂量和给药次数,并于5~6周完成治疗。
Objective To investigate the choice of paclitaxel dosage for radiochemotherapy simultaneously in the treatment of middle-aged and elderly non-small cell lung cancer (NSCLC). Methods Sixty NSCLC patients were selected, including 36 males and 24 females, aged 55-65 years. Randomly divided into A, B, C, D, E 5 group, each group of 12 patients. All patients after three cycles of induction chemotherapy, 1 month after radiotherapy and synchronization. Three-dimensional conformal radiotherapy was completed in 5 to 6 weeks with a total dose of 60 Gy; paclitaxel was used for chemotherapy, twice daily for 10 mg / m2 in group A and twice daily for 15 mg / m2; Group C 2 times / week, each 20 mg / m2; Group D 3 times / week, each 10 mg / m2; Group E 3 times / week, each 15 mg / m2, 6 weeks to complete the treatment. When any group of patients over half of patients during treatment occurred more than 3 degrees of acute adverse reactions to stop the group test. Results All the patients with more than 3 degrees of adverse reactions in group A, B and D 3 did not exceed half of the patients. All the treatments were completed and the total effective rates were 41.67%, 75.00% and 66.67% respectively in the groups A, B and D 3. More than half of patients with adverse reactions to stop the test. Conclusions The optimal dosage of paclitaxel for 30 mg / m2 paclitaxel in patients with locally advanced NSCLC after radiotherapy and chemotherapy is controlled by radiochemotherapy. The dose and dosage of paclitaxel can be adjusted according to the specific physical condition of patients In 5 to 6 weeks to complete the treatment.