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目的 :研究加速超分割放疗和化疗综合治疗局限期小细胞肺癌 (Limitedstagesmall celllungcancer,LSCLC)的耐受性、急性副反应和即期疗效。方法 :入组标准是经组织学或细胞学证实的SCLC ;局限期 (美国退伍军人医院分期法 ) ,但不包括恶性胸腔积液 ;年龄 18— 70岁 ;KPS≥ 6 0 ;无明显心、肺、肝、肾和骨髓功能损害 ;既往无肿瘤病史。入组前检查 :胸部X片、胸CT、脑CT、腹部B超、骨ECT、肺功能、心电图 ,血生化检查 (LDH、AKP、SGPT、SGOT、A G、Na+ )。治疗方法 :首治病人化疗 1疗程后放疗 ,继以化疗 5疗程 ;已治病人化疗 3疗程后放疗 ,继以化疗3疗程。化疗方案 :EP(DDP 2 5— 30mg m2 d1— 3+VP16 5 0— 70mg m2 d1— 3)。放疗方法 :放射源 6MVX线或6 0 Coγ线 ,照射方法 :1 4Gy 次Bid ,间隔≥ 6h ,5天 周 ,总剂量 5 6Gy 40次 4周。第 1— 3周前胸后背相对野照射 ,第 4周改为斜野 ,以避开脊髓。照射范围 :胸部CT显示的原发肿瘤灶及淋巴结转移灶。结果 :按RTOG早期放射反应评价标准评价早期放射反应。放疗后两月评价即期疗效 (按WHO肿瘤即期疗效评价标准 )。 1997年 6月— 2 0 0 0年 3月 ,5 0例病人进入本研究组。男 45例 ,女 5例 ,中位年龄 5 8岁 ( 2 5— 70 )。放疗在第 1疗程化疗后立即开始者 70 %(
Objective : To study the tolerability, acute side effects and immediate therapeutic effects of accelerating hyperfractionated radiotherapy and chemotherapy in the treatment of limited-stage small cell lung cancer (LSCLC). METHODS: The enrollment criteria were histologically or cytologically confirmed SCLC; limitation period (US veterans hospital staging method), but did not include malignant pleural effusions; aged 18-70 years; KPS ≥ 60; Lung, liver, kidney, and bone marrow dysfunction; no previous history of cancer. Check before grouping: chest X-ray, chest CT, brain CT, abdominal B-ultrasound, bone ECT, lung function, electrocardiogram, blood biochemical examination (LDH, AKP, SGPT, SGOT, A G, Na+). Treatment methods: first treatment of patients with chemotherapy after 1 course of radiotherapy, followed by 5 courses of chemotherapy; patients have been treated with chemotherapy after 3 courses of radiotherapy, followed by 3 courses of chemotherapy. Chemotherapy protocol: EP (DDP 25-30 m2 d1-3 + VP16 50-70 mg m2 d1-3). Radiotherapy method: radioactive source 6MVX line or 6 0 Co γ line, irradiation method: 1 4Gy times Bid, interval ≥ 6h, 5 days week, total dose 5 6Gy 40 times 4 weeks. The thoracodorsal back was exposed to field radiation between the first and third weeks, and the fourth week was changed to oblique field to avoid the spinal cord. Range of irradiation: primary tumor foci and lymph node metastases displayed on chest CT. RESULTS : Early radioresponses were evaluated according to the RTOG early radiological evaluation criteria. Two months after radiotherapy, evaluate the curative effect (according to WHO tumor immediate effect evaluation criteria). From June 1997 to March 2000, 50 patients entered the study group. There were 45 males and 5 females with a median age of 5 8 (25-70). Radiotherapy started 70% immediately after the first course of chemotherapy.