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醫(yī)學(xué)論文范文:三維適形放療同步TP方案化療治療局部晚期非小細(xì)胞肺癌
【摘要】 目的 研究三維適形放射治療聯(lián)合多西他賽同期化療治療局部晚期非小細(xì)胞肺癌的療效和毒副作用。方法 63例局部晚期非小細(xì)胞肺癌患者隨機(jī)分成單放組和同期組。單放組30例采用序貫2周期TP方案化療及三維適形放射治療,總劑量66～70 Gy/33～35次, 6～7周完成。同期組33例采用三維適形放射治療同期化療(多西他賽+順鉑)。結(jié)果 兩組患者的總有效率分別為56. 7%和81. 8%,其中完全緩解率分別為6. 7%和27. 3%,差異有統(tǒng)計(jì)學(xué)意義(P<0. 05)。兩組1、2年生存率分別63.5%、79.4%和40.0%、54.5% (P>0.05)。單放組患者中位生存期為11.4個(gè)月, 同期組患者中位生存期為18.9個(gè)月。兩組患者早期放射反應(yīng)主要為Ⅰ～Ⅱ級(jí)放射性食道炎和骨髓抑制,后期放射反應(yīng)主要為Ⅰ～Ⅱ級(jí)放射性肺炎。結(jié)論 三維適形放射治療同期TP方案化療治療局部晚期非小細(xì)胞肺癌，與序貫放化療相比,可提高局部晚期非小細(xì)胞肺癌的近期療效,生存期也有提高的趨勢(shì),但毒副反應(yīng)有增加趨勢(shì)。
【關(guān)鍵詞】 非小細(xì)胞肺癌;三維適形放射治療;化學(xué)治療;多西他賽
An analysis of treatment effectiveness of threedimensional conformal radiotherapy combined with docetaxol in patients with locally advanced nonsmall cell lung cancerLI Chunying, WEI Lin(Dept. of Radiotherapy, Taian City Central Hospital,Taian 271000, China)Abstract:Objective: To evaluate the therapeutic efficacy and the radiation complication of threedimensional conformal radiotherapy (3DCRT) combined docetaxol in patients with locally advanced nonsmall cell lung cancer(NSCLC).Methods: 63 patients with locally advanced NSCLC were randomly divided into two groups. 30 patients in group A received 3DCRT at the total dose of 66 to 70 Gy in 33 to 35 fractions completed in 6 to 7 weeks. In the sequential chemoradiation group, two chemotherapy cycles were given before radiotherapy. 33 patients in group B received 3DCRT combined with Docetaxol. Results: The efficacy rates in group A and B were 56.7% and 81.8%, and the complete remission rates were 6.7% and 27.3% respectively. The differences were statistically significant (P<0.05). The 1 and 2- year survival rates of the patients in groupA and B were 63.5% VS 79.4%, 40.0%VS 54.5% respectively and there was no significant difference (P>0.05). The median survival time in group A and B were 11.4 months and 18. 9months respectively. The major radiation complication observed in the two groups were grade I to II acute radiation esophagitis and hematopoietic toxicity. The later radiation complication in the two groups were grade I to II radiation lung fibrosis. Conclusion: 3DCRT combined with Docetaxol is better in improving response and survival than sequential ones, but there is an ascendant tendency in adverse reaction醫(yī)學(xué)全.在線www.gydjdsj.org.cn.
Key words:nonsmall cell lung cancer; three dimensional conformal radiotherapy; chemotherapy; docetaxol
肺癌已成為目前人類死亡的主要原因,不能手術(shù)的局部晚期非小細(xì)胞肺癌(nonsmall cell lung carcinoma, NSCLC)大約占肺癌的40%,單一治療生存率低,2年生存率僅為10%[1]。放射治療是治療局部晚期非小細(xì)胞肺癌患者的重要手段。近來(lái)多主張化療、放療綜合治療,以期延長(zhǎng)生存期。根據(jù)局部晚期非小細(xì)胞肺癌的生物學(xué)行為和臨床特點(diǎn),我科于2005年10月至2007年10月進(jìn)行了三維適形放射治療聯(lián)合多西他賽+順鉑同期化療治療局部晚期非小細(xì)胞肺癌的臨床研究。結(jié)果報(bào)道如下。
