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目的 评价局限期小细胞肺癌应用化疗和放射治疗时机和顺序的重要性。方法 94例局限期小细胞肺癌按化疗和放射治疗使用的时间和顺序随机分为先化疗后放射治疗组( 简称序贯组,46 例) 和化疗、放射治疗交替组(简称交替组,48 例) 。化疗方案用顺铂(Cisplatin,PDD) + 依托泊甙(Etoposide,VP16)(EP方案) ,顺铂20 mg/m2 ,1～5 天,依托泊甙100 mg/m2 ,1 ～3 天,每3 ～4 周1疗程,共6 疗程。60Co 放射治疗:每次2 Gy,5 周,50 Gy;交替组在第1 个疗程化疗后第3 天开始,序贯组则在6 个疗程化疗结束后。结果 交替组完全缓解率高于序贯组(66 .7 % 对58.7% ),但差异无显著意义(P> 0.05) 。交替组2 年生存率高于序贯组(43.7 % 对23 .9 %) ,差异有显著意义( P<0 .05) 。结论 交替组疗效优于序贯组,提示尽早放射治疗可提高小细胞肺癌生存率;EP方案可作为与放射治疗交替使用的首选化疗方案
Objective To evaluate the importance of the timing and sequence of chemotherapy and radiation therapy for limited-stage small cell lung cancer. Methods Ninety-four patients with limited-stage SCLC were randomly divided into radiation therapy group (abbreviated as sequential group, 46 cases) and chemotherapy and radiation therapy alternating group (abbreviated as alternating group, 48 cases) according to the time and sequence of chemotherapy and radiation therapy. ). Chemotherapy regimens are Cisplatin (PDD) + Etoposide (VP-16) (EP regimen), Cisplatin 20 mg/m2 for 1 to 5 days, and Etoposide 100 mg/m2 for 1 to 3 days , every 3 to 4 weeks 1 course of treatment, a total of 6 courses. 60Co radiation therapy: 2 Gy each time, 5 weeks, and 50 Gy; alternating group started on the 3rd day after the first course of chemotherapy, and the sequential group ended after 6 courses of chemotherapy. Results The complete remission rate in the alternating group was higher than that in the sequential group (66.7% vs. 58.7%), but the difference was not significant (P> 0.05). The 2-year survival rate in the alternating group was higher than that in the sequential group (43.7 % vs. 23.9 %), and the difference was significant (P < .05). Conclusions The efficacy of the alternating group is better than that of the sequential group, suggesting that early radiation therapy can improve the survival rate of small cell lung cancer; EP regimen can be used as the first choice for chemotherapy alternating with radiation therapy.