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目的探讨参芪扶正注射液配合后程三维适形放疗(three-dimensional conformal radiation therapy,3D-CRT)同步依托泊苷+顺铂(Etoposide+Cisplatin,EP)方案化疗治疗小细胞肺癌(small cell lung cancer,SCLC)伴脑转移癌的疗效及不良反应。方法 36例患者利用随机数字表法分为观察组(19例)和对照组(17例),两组均行后程三维适形放疗同步EP方案化疗,间隔3周后用EP方案化疗2~6个周期,28 d为一周期。观察组加用参芪扶正注射液,第1~21 d每日一次静脉滴注250 ml,28 d为一周期。用参芪扶正注射液2周期后,观察两组的疗效及不良反应,随访2年评价远期疗效。结果观察组有效率(89.4%)高于对照组(82.3%),两组比较差异无统计学意义(P>0.05)。观察组Karnofsky计分提高+稳定者占84.2%(16/19),高于对照组的52.9%(9/17),两组比较差异有统计学意义(P<0.05)。观察组白细胞下降、血小板减少、恶心呕吐等不良反应发生率低于对照组,两组比较差异有统计学意义(P<0.05)。两组1、2年生存率比较差异无统计学意义(P>0.05)。结论参芪扶正注射液配合后程三维适形放疗同步EP方案化疗治疗SCLC脑转移能改善患者生活质量、减轻放化疗的不良反应。
Objective To investigate the therapeutic effect of Shenqi Fuzheng injection combined with Etoposide + Cisplatin (EP) chemotherapy after three-dimensional conformal radiation therapy (3D-CRT) on small cell lung cancer, SCLC) with brain metastases. Methods Thirty - six patients were divided into observation group (n = 19) and control group (n = 17) by random number table. Both groups underwent three - dimensional conformal radiotherapy (EP) 6 cycles, 28 d for a cycle. The observation group plus Shenqi Fuzheng injection, 1 to 21 d once daily intravenous infusion of 250 ml, 28 d for a cycle. With Shenqi Fuzheng injection two cycles, the two groups observed the efficacy and adverse reactions, follow-up 2 years to evaluate the long-term efficacy. Results The effective rate of the observation group (89.4%) was higher than that of the control group (82.3%). There was no significant difference between the two groups (P> 0.05). The observation group Karnofsky score improved + stable accounted for 84.2% (16/19), 52.9% (9/17) higher than the control group, the difference between the two groups was statistically significant (P <0.05). In the observation group, the incidence of leukopenia, thrombocytopenia and nausea and vomiting were lower than those in the control group, with significant difference between the two groups (P <0.05). There was no significant difference in the 1 and 2 year survival rates between the two groups (P> 0.05). Conclusion Shenqi Fuzheng injection combined with posterior three-dimensional conformal radiotherapy and simultaneous EP regimen chemotherapy in the treatment of SCLC brain metastases can improve the quality of life of patients and reduce the adverse reactions of radiotherapy and chemotherapy.