南方医科大学学报2012，Vol.32Issue(3)：362-367,6.DOI:44-1627/R.20120307.1635.018
93例Ⅲ期非小细胞肺癌同步放化疗加巩固化疗与序贯放化疗的对比研究
Concurrent chemoradiotherapy followed by consolidation chemotherapy and sequential chemoradiotherapy for stage Ⅲ non-small cell lung cancer, comparison in 93 patients
摘要
Abstract
Objective To compare the efficacy and toxicity of concurrent chemoradiotherapy followed by consolidation chemotherapy (CCRT-CT) and sequential chemoradiotherapy (SORT) in the treatment of stage HI non-small cell lung cancer. Methods From February, 2007 to June, 2010, 93 patients with unresectable stage III non-small cell lung cancer were treated with SCRT or CCRT-CT. SCRT group (50 cases) received radiotherapy after 2-6 cycles of chemotherapy (median 2 cycles) followed by 0-4 cycles (median 2 cycles) of chemotherapy. CCRT-CT group (43 cases) received 2 cycles of chemotherapy every 3 weeks with concurrent radiotherapy followed by 2-4 cycles (median 2 cycles) of chemotherapy with the same drugs. The chemotherapy consisted of cisplatin plus gemcitabine, docetaxel or vinorelbine. Radiotherapy was administered using two-dimensional conformed irradiation (36-40 Gy/18-20f) followed by three-dimensional conformal boost to 56-70 Gy/28-35f (median DT64Gy) or using three-dimensional conformal irradiation 50-74 Gy/25-37f (median DT62Gy). Results The response rates were 76.7% and 54.0% in CCRT-CT and SCRT group, respectively (P<0.05). The median progression-free time in the two groups was 16.0 and 10.0 months, with the overall survival time of 18.0 and 12.5 months, respectively. The 1-, 2- and 3-year overall survival rates were 83.7%, 48.8% and 20.9% in CCRT-CT group and 52.0%, 20.0%, and 2.0% in SCRT group, respectively (P<0.05). CCRT-CT group showed a significantly lower rate of distant metastasis than SCRT group (P<0.05), but the local recurrence rate was similar between the two groups. The main side effects included radiation pneumonitis, radiation esophagitis, nausea/vomiting and anemia/leucopenia/thrombocytopenia. CCRT-CT group had a significantly higher rate of Ⅲ-IV grade nausea/vomiting and anemia/leucopenia/thrombocytopenia than SCRT group. Conclusion Compared to SCRT, CCRT-CT can improve the response rate, progression free survival and overall survival and decrease the rate of distant metastasis, but is associated with a higher toxicity.关键词
癌,非小细胞肺/放射治疗/癌,非小细胞肺/化学治疗/毒副反应Key words
carcinoma, non-small cell lung/radiotherapy/ carcinoma, non-small cell lung/chemotherapy/ toxicity分类
医药卫生引用本文复制引用
孙文泽,宋丽萍,张莹冰,艾婷,卢金利,任娟,高莹..93例Ⅲ期非小细胞肺癌同步放化疗加巩固化疗与序贯放化疗的对比研究[J].南方医科大学学报,2012,32(3):362-367,6.基金项目
陕西省自然科学基金(2011JM4037) （2011JM4037）
