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目的:回顾性分析同期放化疗与序贯放化治疗Ш期不能手术非小细胞肺癌的近期疗效、生存期及毒性反应,以指导临床治疗。方法:对生存资料完整的86例经组织学或细胞学证实的非小细胞肺癌病例进行回顾性分析,序贯放化组42例,同期化放组44例。同期放化疗组:治疗方式为放疗期间周期性化疗,三维适形调强放疗。治疗后不常规进行巩固化疗,随访如血液肿瘤标志物CEA数值动态观察增高,则进行全身化疗1～2周期。序贯化放疗组先化疗3～7周期后放疗,放疗方法与同期放化疗组相同。结果:同期化放组肿瘤完全缓解率显著高于序贯化放疗组的(P<0.05);中位生存期分别为24与18个月,1、2年生存率分别为88%、49%和84%、35%(P<0.05);急性期毒副反应经对症后均恢复而未影响治疗,两组病例中的毒副反应相似,差别无统计学意义。结论:同步放化疗较序贯放化疗治疗Ш期非小细胞肺癌能提高完全缓解率、中位生存时间、1、2年生存率,且未增加患者的毒性反应,为Ш期非小细胞肺癌提供一种安全有效的治疗方法 。
OBJECTIVE: To retrospectively analyze the short-term efficacy, survival duration and toxicity of concurrent chemoradiation and sequential radiotherapy and chemotherapy for unresectable non-small cell lung cancer in order to guide clinical treatment. Methods: A retrospective analysis was performed on 86 cases of histologically confirmed or cytologically confirmed non-small cell lung cancer with complete survival data. Forty-two patients received sequential radiotherapy and 44 patients received concurrent radiotherapy. Radiotherapy and chemotherapy group over the same period: the treatment for periodic chemotherapy during radiotherapy, three-dimensional conformal IMRT. Unconventional consolidation chemotherapy after treatment, follow-up, such as increased blood tumor markers CEA dynamic observation, then the whole body chemotherapy 1 to 2 cycles. Sequential radiotherapy group after the first chemotherapy 3 to 7 cycles of radiotherapy and radiotherapy methods with the same period of radiotherapy and chemotherapy group. Results: The complete remission rate was significantly higher in sequential radiotherapy group than in sequential radiotherapy group (P <0.05). The median survival time was 24 and 18 months respectively. The 1- and 2-year survival rates were 88% and 49% And 84%, 35% respectively (P <0.05) .Acute toxicities and side effects recovered after symptomatic treatment but did not affect the treatment. There was no significant difference between the two groups in the side effects. Conclusions: Concurrent concurrent chemoradiotherapy is more effective than sequential chemotherapy in the treatment of non-small cell lung cancer in Ш stage, which can improve the complete remission rate, median survival time, 1 year and 2 year survival rate, and does not increase the toxic reaction in patients with Ш stage non-small cell lung cancer Provide a safe and effective treatment.