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目的评价长春瑞滨加卡铂(NC)联合同期高剂量70 Gy的三维适形放射治疗非小细胞肺癌的耐受性,并初步观察其疗效。方法病理或细胞学确诊的晚期非小细胞肺癌接受同期放化疗。均采用三维适型放射治疗,常规分割照射,2 Gy/f,1 f/d,5 f/周,总剂量70 Gy,每例患者放疗计划均满足:双肺V20≤30%且V30≤20%。放疗第一天开始长春瑞滨联合卡铂(NC)方案化疗:NVB 25mg/m2,d1,d8,CBP,AUC=5 mg/ml.m2,d8,每28 d重复,同期化疗两周期,放疗结束后最多4周期。结果 37例患者成为研究对象。血液学毒性为86.5%(32/37),Ⅲ/Ⅳ级中性粒细胞减少为18.9%(7/37),Ⅲ/Ⅳ级血小板减少为8.1%(3/37),无Ⅲ级及以上贫血发生。非血液学毒性:Ⅲ级放射性肺炎8.1%(3/37),Ⅲ级放射性食管炎13.5%(5/37),全组无Ⅳ/Ⅴ级非血液学毒性发生。全组完全缓解率(CR)为13.5%(5/37),部分缓解率(PR)64.9%(24/37),近期有效率为(CR+PR)78.4%(29/37)。中位生存期为12.0个月,1年总生存率为45.1%。结论在V20≤30%和V30≤22%的情况下,长春瑞滨加卡铂联合同期70 Gy的三维适型放射治疗非小细胞肺癌可以耐受,有较好的近期有效率、中位生存期和1年总生存率,其远期疗效值得进一步研究。
OBJECTIVE: To evaluate the tolerability of vinorelbine plus carboplatin (NC) in combination with high-dose, 70 Gy, three-dimensional conformal radiotherapy for non-small cell lung cancer (NSCLC). Methods Pathologically or cytologically confirmed advanced non-small cell lung cancer received concurrent chemoradiotherapy. All patients were treated with three-dimensional stereotactic radiotherapy, 2 Gy / f, 1 f / d, 5 f / week, and total dose of 70 Gy. The radiotherapy plans of each patient were satisfied: V20≤30% and V30≤20 %. On the first day of radiotherapy, vinorelbine plus carboplatin (NC) regimen was given: NVB 25 mg / m2, d1, d8, CBP, AUC = 5 mg / ml.m2, d8 every 28 d, Up to 4 cycles after the end. Results 37 patients became the research object. Hematological toxicity was 86.5% (32/37), grade Ⅲ / Ⅳ neutropenia was 18.9% (7/37), grade Ⅲ / Ⅳ thrombocytopenia was 8.1% (3/37), grade Ⅲ and above Anemia occurs. Non-hematologic toxicity: grade Ⅲ pneumonia 8.1% (3/37), grade Ⅲ radiation esophagitis 13.5% (5/37), the whole group without grade Ⅳ / Ⅴ non-hematological toxicity. The overall CR rate was 13.5% (5/37), partial response rate (PR) was 64.9% (24/37), and the recent effective rate was (CR + PR) 78.4% (29/37). The median survival was 12.0 months and the 1-year overall survival was 45.1%. Conclusions In the condition of V20≤30% and V30≤22%, vinorelbine plus carboplatin in combination with 70 Gy three-dimensional conformal radiation therapy for non-small cell lung cancer can be tolerated with good short-term effective and median survival Term and 1-year overall survival rate, its long-term efficacy deserves further study.