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为了评价三维适形放疗同步紫杉醇+顺铂化疗治疗局部晚期非小细胞肺癌(NSCLC)的疗效和放射反应,对收治的65例不能手术的Ⅲ期NSCLC患者进行三维适形放疗加同步化疗,化疗方案全部采用PC方案:紫杉醇75mg/m2,d1、d8静脉滴入;顺铂30mg/m2、d1～d3静脉滴入,每21d为1个周期。放疗设备采用西门子直线加速器,6MV-X线,CT模拟定位,放疗中位剂量60Gy,6周完成。靶区为原发肿瘤及受侵的纵隔淋巴结区,放射治疗结束后2个月评价疗效。CR8例(12.3%),PR45例(69.2%),无变化12例(18.5%),总有效率(CR+PR)81.5%。1年生存率72.3%(47/65)。急性毒副反应主要是骨髓抑制、放射性食管炎和放射性肺炎,以1～2级为主,7例(10.8%)出现3级骨髓抑制。晚期毒副反应均为1～2级放射性肺炎。初步研究结果提示,三维适形放疗结合紫杉醇+顺铂化疗治疗局部晚期NSCLC耐受性较好,均可完成治疗计划,短期疗效好,远期疗效有待进一步观察。
To evaluate the efficacy and radiotherapy of three-dimensional conformal radiotherapy combined with paclitaxel plus cisplatin chemotherapy in the treatment of locally advanced non-small cell lung cancer (NSCLC), three-dimensional conformal radiotherapy combined with concurrent chemotherapy and chemotherapy were given to 65 patients with unresectable stage Ⅲ NSCLC All programs using PC program: paclitaxel 75mg / m2, d1, d8 intravenous; cisplatin 30mg / m2, d1 ~ d3 intravenous infusion every 21d for a cycle. Radiotherapy equipment using Siemens linear accelerator, 6MV-X line, CT simulation positioning, the median dose of radiation 60Gy, 6 weeks to complete. Target area for the primary tumor and mediastinal lymph node invasion, 2 months after the end of radiotherapy to evaluate the efficacy. CR8 cases (12.3%), PR45 cases (69.2%), no changes in 12 cases (18.5%), the total effective rate (CR + PR) 81.5%. One-year survival rate was 72.3% (47/65). Acute toxicity was mainly myelosuppression, radiation esophagitis and radiation pneumonitis, mainly in grades 1 and 2, and grade 3 myelosuppression in 7 cases (10.8%). Late toxic reactions are 1 to 2 radiation pneumonitis. Preliminary findings suggest that three-dimensional conformal radiotherapy combined with paclitaxel + cisplatin chemotherapy is better tolerable locally advanced NSCLC, can complete the treatment plan, short-term curative effect, long-term efficacy remains to be further observed.