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目的探讨提高局部晚期非小细胞肺癌(NSCLC)患者生存期的治疗方法。方法用三维适形放射治疗(3D-CRT)加长春瑞滨(NVB)、顺铂(DDP)方案(NP)同期化疗治疗局部NSCLC。12例患者作为治疗组:诱导化疗用NVB25mg/m2加入生理盐水(NS)100ml,快速静脉滴注,d1,d5;DDP80mg/m2,静脉滴注,d1,d2,d3;28d为1周期,连续2周期。放疗开始后同期化疗,用NVB25mg/m2加NS100ml静脉滴注;DDP25mg/m2加NS500ml静脉滴注,放疗的间隙每周给药1次,给药2周,休息2周,直至放疗结束。放射治疗:第2周期诱导化疗结束后开始常规放疗,每次2Gy,每周5次,TD40Gy/4周。结束后,予以3D-CRT局部加量,每次2Gy,每周5次,TD30～34Gy/3～3.5周。14例患者作为对照组:诱导化疗及常规放射治疗同治疗组。结束后予以常规放射治疗缩野至原发灶及转移的淋巴结,追加2600～3000Gy/2.6～3周。放疗结束后序惯化疗,即予以2～4周期的NP方案,剂量及给药方法同诱导化疗,28d为1个给药周期。结果治疗组1、2年观察期末生存率为92%和61%,对照组为57%和14%(P<0.05)。两组患者均没有发生严重的放化疗毒副反应。结论3D-CRT加NP方案同期化疗治疗局部晚期NSCLC可以提高肿瘤的局部控制率,提高疗效。
Objective To investigate the treatment of patients with locally advanced non-small cell lung cancer (NSCLC). Methods Three-dimensional conformal radiotherapy (3D-CRT) plus vinorelbine (NVB), cisplatin (DDP) regimen (NP) concurrent chemotherapy for the treatment of local NSCLC. Twelve patients were treated with NVB25mg / m2 as induction chemotherapy followed by intravenous infusion of 100ml normal saline (NS), d1 and d5, DDP80mg / m2, d1, d2 and d3 for 28 days, 2 cycles. Radiotherapy started after the same period of chemotherapy, with NVB25mg / m2 plus NS100ml intravenous drip; DDP25mg / m2 plus NS500ml intravenous infusion of radiotherapy clearance once a week for 2 weeks, rest for 2 weeks until the end of radiotherapy. Radiation therapy: The second cycle of induction chemotherapy after the start of conventional radiotherapy, each 2Gy, 5 times a week, TD40Gy / 4 weeks. After the end, to 3D-CRT local dosage, each 2Gy, 5 times a week, TD30 ~ 34Gy / 3 ~ 3.5 weeks. Fourteen patients served as control group: induction chemotherapy and conventional radiotherapy with treatment group. After the end of conventional radiotherapy to shrink to the primary tumor and lymph node metastasis, the additional 2600 ~ 3000Gy / 2.6 ~ 3 weeks. After the end of radiotherapy and chemotherapy, that is to be 2 to 4 cycles of NP regimen, dosage and administration method with induction chemotherapy, 28d for a dosing cycle. Results The survival rates at the end of the observation period of 1 and 2 years were 92% and 61% in the treatment group and 57% and 14% in the control group (P <0.05). No serious adverse effects of radiotherapy and chemotherapy occurred in both groups. Conclusion 3D-CRT plus NP regimen concurrent chemotherapy for locally advanced NSCLC can improve the local control rate of tumor and improve the curative effect.