Clinical Observation of NP Chemotherapy Combined with Intensity-modulated Radiotherapy in Treating stage-ⅢNon-small Cell Lung Cancer
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摘要:
目的 探讨NP方案联合调强放疗治疗局部晚期非小细胞肺癌的临床疗效和不良作用。 方法 72例Ⅲ期非小细胞肺癌患者随机分为2组, 治疗组36例给予NP方案化疗, 长春瑞滨25 mg/m2, d1, d8;DDP 75mg/m2, d1, 21d为1个周期, 至少2个周期。化疗同时给予调强常规分割放疗, 照射剂量为60~64Gy。对照组36例仅给予相同方法的放疗。治疗完成4周后评价疗效及不良反应。 结果 治疗组与对照组的有效率(RR)分别为72.2%和41.7%(P < 0.05), 中位疾病进展时间(TTP)分别为7.2个月和5.8个月。治疗组与对照组的主要不良反应: Ⅲ~Ⅳ度骨髓抑制分别为20例和5例, Ⅲ~Ⅳ度胃肠道反应为6例和0例, Ⅲ~Ⅳ度放射性食管炎和放射性肺炎为4例和3例、5例和2例。 结论 NP方案化疗联合同步调强放疗对局部晚期非小细胞肺癌有较好的近期疗效, 不良反应可以耐受。 Abstract:Objective This study aims to investigate the clinical effects and tolerance of NP chemotherapy combined with intensi ty-modulated radiotherapy in treating stage Ⅲ non-small cell lung cancer (NSCLC) Methods A total of 72 patients with stage Ⅲ NSCLC were divided into two groups, namely, experimental group (EG) and control group (CG). The patients in EG were treated with NP chemotherapy and radiotherapy. The NP regimen included vinorelbine (25 mg/m2, dl, dS) and DDP (75 mg/m2, dl), which was repeated every 21 days. Intensity-modulated radiotherapy was performed on the first day of chemotherapy, with a total dose of 60 Gy to 64 Gy. Meanwhile, patients in CG underwent radiotherapy only. Results The overall response rate among patients who received NP chemotherapy and ra- diotherapy treatment was 72.2% and 41.7% in EG and CG, respectively. The median time to progression (TTP) of the patients in EG and CG was 7.2 and 5.8 months, respectively. Grade 3-4 bone marrow suppression was observed in 20 and five patients in EG and CG, respectively. Grade 3-4 gastrointestinal reaction was observed in six patients in EG and 0 in CG. Radiation esophagitis was observed in four and three patients, whereas radiation pneumonitis was observed in five and two patients in EG and CG, respectively. Conclusion NP chemotherapy combined with intensity-modulated radiotherapy has good therapeutic effects for NSCLC patients, with tolerable toxicity. -
Key words:
- Vinorelbine /
- DDP /
- Chemotherapy /
- Radiotherapy /
- Intensity-modulated radiotherapy /
- Non-small cell lung cancer
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表 1 两组患者一般情况比较
Table 1. Comparison of ordinary circumstances of the patients between the two groups
表 2 两组患者近期疗效比较 例（%）
Table 2. Comparison of the short-term curative effects between the two groups
表 3 两组患者治疗毒副反应比较 例（%）
Table 3. Comparison of the toxic side effects between the two groups
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[1] Laskin JJ, Sandler AB. First-line treatment for advanced non-small cell lung cancer[J]. Oncology (Willi ston Park), 2005, 19(13): 1671-1676. [2] 朱广迎, 申戈. 局部晚期非小细胞肺癌同步放疗规范[J]. 癌症进展杂志, 2009, 7(4): 370-378. https://www.cnki.com.cn/Article/CJFDTOTAL-FAIZ201611004.htm [3] Jemal A, Siegel R, Ward E, et al. Cancer statistic, 2009[J]. CA Cancer J Clin, 2009, 59(4): 225-249. doi: 10.3322/caac.20006 [4] 汤钊猷. 主编. 现代肿瘤学[M]. 第2版. 上海: 上海医科大学出版社, 2000: 877-878. [5] Fossella FV, DeVore R, Kerr RN, et al. Randomized phase Ⅲ trial of docetaxel versus vinorelbine or ifosfamide in patients with advanced Non-small-cell lung cancer previously treated with platinum containing chemotherapy regimens[J]. J Clin Oncol, 2000, 18(12): 2354-2362. doi: 10.1200/JCO.2000.18.12.2354 [6] 刘朝晖. 长春瑞滨联合顺铂治疗晚期非小细胞肺癌64例疗效观察[J]. 药物与临床, 2011, 1(19): 100-101. https://www.cnki.com.cn/Article/CJFDTOTAL-SZXL200605005.htm [7] 刘素勤, 孙亮新, 班丽英, 等. 参一胶囊联合NP方案治疗晚期非小细胞肺癌的临床观察[J]. 临床肿瘤学杂志, 2007, 12(11): 848-850. https://www.cnki.com.cn/Article/CJFDTOTAL-LCZL200711015.htm [8] De Petris L, Lax I, Siren F, et al. Role of gross tumor volume on outcome and of dose parameters on toxicity of patients under going chemoradiotherapy for locally advanced non-small cell lung cancer[J]. Medical Oncol, 2005, 2(24): 375-381. [9] 王俊超, 刘慧忠, 郝澄澄, 等. 三维适形放疗加甘氨双哇钠增敏治疗局限晚期非小细胞肺癌的疗效分析[J]. 山东大学学报(医学版), 2009, 47(1): 91-94. https://www.cnki.com.cn/Article/CJFDTOTAL-SDYB200901023.htm [10] 刘泰福. 主编. 现代放射肿瘤学[M]. 上海: 复旦大学出版社上海医科大学出版社, 2001: 345-346 [11] Ready NE, Vokes EE. Induction or consolidation systemic therapy in the multimodality treatment of unresectable locally advanced non-small cell lung cancer[J]. Lung Cancer, 2010, 42(1): 65-69. [12] 周绍兵, 刘阳晨, 高飞, 等. 后程适形放疗治疗联合NP方案同步化疗治疗Ⅲ期非小细胞肺癌[J]. 临床肿瘤学杂志, 2010, 15(2): 171-172. doi: 10.3969/j.issn.1009-0460.2010.02.021 [13] 张建东, 于金明, 张晓涛, 等. 老年局部晚期非小细胞肺癌适形放疗协同诱导化疗的临床研究[J]. 中国肿瘤临床, 2006, 33(22): 1294-1295. http://www.cjco.cn/cn/article/doi/ [14] 石磊, 乔文波, 刘晖, 等. 长春瑞滨联合顺铂同步放疗治疗局部晚期非小细胞肺癌[J]. 肿瘤防治研究, 2011, 38(5): 562-566. doi: 10.3971/j.issn.1000-8578.2011.05.023 [15] 刘冬英, 吴海鹰, 张力, 等. 口服长春瑞滨联合顺铂与静滴长春瑞滨联合顺铂治疗局部晚期或转移的非小细胞肺癌的Ⅱ期临床研究[J]. 中国肿瘤临床, 2010, 37(14): 820-824. doi: 10.3969/j.issn.1000-8179.2010.14.012 [16] Rose J, Rodrigues G, Yaremko B, et al. Systematic review of dose-volume parameters in the prediction of esophagitis in the thoracic radiotherapy[J]. Radiother Oncol, 2009, 91(3): 282-287. doi: 10.1016/j.radonc.2008.09.010 -
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