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目的:评价三维适形放射治疗(3D-CRT)加同期化疗(NP方案)治疗局部晚期非小细胞肺癌(NSCLC)的临床疗效和并发症。方法:12例患者作为观察组:诱导化疗:长春瑞滨(NVB)25 mg/m2加入生理盐水(NS)100 ml,快速静脉滴注,d1,d5;顺铂(DDP)80 mg/m2,静脉滴注。28天1周期,连续2周期。同期化疗:放疗开始后:NVB 25 mg/m2加NS100 ml静脉滴注;DDP 25 mg/m2加NS 500 ml静脉滴注,于放疗的间隙每周给药一次,给药2周,休息2周,直至放疗结束。放射治疗:常规放疗于第2周期诱导化疗结束后开始。每次2 Gy,每周5次,TD 40 Gy/4周。结束后,予以3D-CRT局部加量。每次2 Gy,每周5次,TD 30～34 Gy/3～3.5周。14例患者作为对照组:诱导化疗及常规放射治疗同治疗组。结束后予以常规放射治疗缩野至原发灶及转移的淋巴结,追加26～30 Gy/2.6～3周。序惯化疗:放疗结束后即予以2～4周期的NP方案,剂量及给药方法同诱导化疗,28天为1个给药周期。结果:观察组1、2年观察期末生存率为92%和61%,而对照组为57%和14%,log-rank检验P<0.05。两组患者均未发生严重放化疗毒副反应。结论:3D-CRT加NP方案同期化疗治疗局部晚期NSCLC可以提高肿瘤的局部控制率,提高疗效。
Objective: To evaluate the clinical efficacy and complications of three-dimensional conformal radiotherapy (3D-CRT) plus concurrent chemotherapy (NP regimen) in the treatment of locally advanced non-small cell lung cancer (NSCLC). Methods: Twelve patients were treated by induction chemotherapy: vinblastine (NVB) 25 mg / m2 was added to 100 ml of NS for rapid intravenous infusion, d1 and d5, and 80 mg / m2 of cisplatin (DDP) Intravenous infusion. 28 days 1 cycle, 2 consecutive cycles. Chemotherapy at the same period: After the start of radiotherapy: NVB 25 mg / m2 plus NS100 ml intravenous drip; DDP 25 mg / m2 plus NS 500 ml intravenous infusion in the radiotherapy interval once a week for 2 weeks, rest for 2 weeks Until the end of radiotherapy. Radiation therapy: Routine radiotherapy begins after the induction chemotherapy cycle 2. 2 Gy per time, 5 times per week, TD 40 Gy / 4 weeks. After the end, to be 3D-CRT local dosage. 2 Gy each time, 5 times a week, TD 30 ~ 34 Gy / 3 ~ 3.5 weeks. Fourteen patients served as control group: induction chemotherapy and conventional radiotherapy with treatment group. After the end of conventional radiotherapy to shrink to the primary tumor and lymph node metastasis, additional 26 ~ 30 Gy / 2.6 ~ 3 weeks. Regimen used to chemotherapy: 2 to 4 cycles after the end of radiotherapy NP regimen, dose and administration method with induction chemotherapy, 28 days for a dosing cycle. Results: At the end of the observation period of 1 and 2 years, the observation group had 92% and 61% survival rates compared with 57% and 14% in the control group, respectively, and the log-rank test P <0.05. Two groups of patients did not occur serious radiotherapy and chemotherapy toxicity. Conclusion: The concurrent chemotherapy with 3D-CRT and NP regimen in the treatment of locally advanced NSCLC can improve the local control rate of tumor and improve the curative effect.