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目的:评价顺铂(PDD)联合依托泊甙(VP16)化疗加后程适形放疗(latecourseconformalradiotherapy,LCCR)对Ⅲ期非小细胞肺癌(NSCLC)的疗效及毒副作用。方法:62例不能手术的Ⅲ期NSCLC患者随机分为两组:治疗组29例每周接受1次PDD20mg、VP1675mg化疗,连续5～6周,同时配合后程适形放疗:先设前后对穿野照射DT40Gy,20次/4周,后用三维适形放疗补充DT24Gy,3Gy/次,5次/周。对照组单纯行后程适形放疗。结果:治疗组总有效率(CR+PR)为82.8%,完全缓解率(CR)为10.3%;对照组总有效率为54.6%,CR率18.0%,两组间总有效率差异有显著性(χ2=4.41,P=0.038)。中位生存期、1、2年生存率治疗组分别为12.8个月、52.2%和27.3%;对照组分别为9.8个月、42.8%和18.4%,两组间差异无显著性(P>0.05)。化疗的毒副反应主要是骨髓抑制和消化道反应,但均可耐受。结论:后程适形放疗同期顺铂加依托泊甙化疗治疗Ⅲ期NSCLC可明显提高近期有效率,但未能提高生存率。
Objective: To evaluate the efficacy and side effects of cisplatin (PDD) plus etoposide (VP16) plus latecourseconformalradiotherapy (LCCR) on stage Ⅲ non-small cell lung cancer (NSCLC). Methods: Sixty-two patients with unresectable stage Ⅲ NSCLC were randomly divided into two groups: 29 cases in the treatment group received 20 mg PDD and VP1675 mg chemotherapy once a week for 5 to 6 weeks, and followed the course of conformal radiotherapy: Field irradiation DT40Gy, 20 times / 4 weeks, followed by three-dimensional conformal radiotherapy to add DT24Gy, 3Gy / time, 5 times / week. The control group after a single line of conformal radiotherapy. Results: The total effective rate (CR + PR) in treatment group was 82.8%, and the complete remission rate (CR) was 10.3%. The total effective rate was 54.6% in control group and 18.0% in CR rate. There was significant difference between the two groups (χ2 = 4.41, P = 0.038). The median survival and 1-year and 2-year survival rates were 12.8 months, 52.2% and 27.3% in the treatment group and 9.8 months, 42.8% and 18.4% in the control group respectively, with no significant difference between the two groups (P> 0.05 ). The main side effects of chemotherapy are myelosuppression and gastrointestinal reactions, but can be tolerated. Conclusion: Late conformal radiotherapy cisplatin plus etoposide chemotherapy for stage Ⅲ NSCLC can significantly improve the recent efficiency, but failed to improve the survival rate.