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目的观察甘氨双唑钠(CM-Na)联合同步放化疗治疗非小细胞肺癌(NSCLC)合并肺不张患者的增敏疗效及不良反应。方法将90例初诊为NSCLC患者按随机分组原则分为增敏组和对照组,每组45例。对照组采用调强放疗(IMRT)+化疗,放疗总剂量DT60~70Gy;鳞癌患者化疗采用紫杉醇+奈达铂(TP)方案,腺癌患者化疗采用培美曲塞+顺铂(PP)方案。增敏组在同步放化疗的基础上予甘氨双唑钠800mg/m2,30min内经静脉滴注完,在60min内行放疗,每周1、3、5给药,至放疗结束。记录2组患者肺复张需重新定位CT时的照射剂量与患者例数,并比较2组治疗后原发灶退缩情况、纵隔淋巴结退缩情况及不良反应。结果增敏组和对照组在放疗过程中因为肺复张需要重新进行CT定位时的患者分别为44例、36例,放疗中位剂量分别为36.16Gy、47.04Gy,2组比较差异具有统计学意义(P<0.05)。增敏组和对照组患者治疗结束时近期有效率分别为97.8%、86.6%,纵隔淋巴结近期退缩有效率分别为100.0%、91.1%,2组比较差异有统计学意义(P<0.05)。2组放射性肺炎等不良反应发生率比较差异无统计学意义(P>0.05)。结论甘氨双唑钠联合同步放化疗能提高NSCLC合并肺不张患者的近期疗效,同时不增加不良反应,但是远期疗效及不良反应还需进一步随访观察。
Objective To observe the sensitizing effects and side effects of glycopyrrolate sodium (CM-Na) combined with concurrent chemoradiotherapy in the treatment of non-small cell lung cancer (NSCLC) with atelectasis. Methods 90 cases of newly diagnosed as NSCLC patients were randomly divided into sensitization group and control group, 45 cases in each group. The control group received IMRT plus chemotherapy, and the total dose of DT was 60-70 Gy. Chemotherapy of squamous cell carcinoma was treated with paclitaxel + nedaplatin (TP), and chemotherapy with pemetrexed + cisplatin (PP) . Sensitization group on the basis of concurrent chemoradiation glycopyrrolate sodium 800mg / m2,30min within the intravenous drip finished radiotherapy 60min, weekly 1,3,5 dosing, to the end of radiotherapy. Record 2 groups of patients with pulmonary recanalization to be re-positioning of CT dose and the number of cases of patients, and to compare the two groups after treatment of primary tumor regression, mediastinal lymph node regression and adverse reactions. Results In the radiosensitization group and the control group, 44 cases and 36 cases required reoperation of CT for pulmonary recanalization, respectively. The median dose of radiotherapy was 36.16 Gy and 47.04 Gy, respectively. The difference between the two groups was statistically significant Significance (P <0.05). The effective rates of the patients in the sensitized group and the control group at the end of treatment were 97.8% and 86.6%, respectively. The effective rate of immediate mediastinal lymph node retraction was 100.0% and 91.1% respectively. There was significant difference between the two groups (P <0.05). The incidence of adverse reactions such as radiation pneumonitis in the two groups showed no significant difference (P> 0.05). Conclusions Combination of glycopyrrolate sodium and concurrent chemoradiotherapy can improve the short-term curative effect of NSCLC patients with atelectasis without increasing the adverse reaction, but the long-term curative effect and adverse reactions need to be followed up further.