Concurrent three dimension conformal radiation therapy and chemotherapy followed by consolidation chemotherapy for locally advanced non-small cell lung cancer
- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF RADIATION ONCOLOGY
- Issue:
- 6
- DOI:
- 10.3760/j.issn:1004-4221.2007.06.005
- Key Word:
- 癌,非小细胞肺/三维适形放射疗法;癌,非小细胞肺/化学疗法;同时放化疗;巩固化疗;预后
Abstract： 目的 探讨局部晚期非小细胞肺癌(NSCLC)的综合治疗方法,比较同时放化疗+巩固化疗(CCT)和同时放化疗(CRT)的近远期疗效及毒副反应.方法 局部晚期NSCLC 90例,随机均分成2个组.CCT组采用先按CRT组进行治疗结束后再进行两周期巩固化疗,CRT组采用多西他赛和顺铂每周化疗同时放疗.放疗采用三维适形放疗,胸部照射2 Gy/次,5次/周,共5.5～6.6周,总剂量56～66 Gy.化疗CRT组采用多西他赛30 mg/m2和顺铂20 mg/m2,第1、8、22、29天分别在第1、6、16、21次放疗前2 h给予.CCT组先按CRT组方案治疗结束后再加用多西他赛75 mg/m2和顺铂100mg/m2巩固化疗,每3周重复,共两周期.结果 CRT组和CCT组有效率分别为69%和76%(P=0.480).CRT组和CCT组中位无进展生存时间分别为12.0个月(95%可信区间10.1～13.9个月)和14.5个月(95%可信区间11.8～17.2个月),中位生存时间分别为16.0个月(95%可信区间11.7～20.3个月)和16.0个月(95%可信区间13.5～18.5个月).CRT组和CCT组1、2、3年无进展生存率分别为56%和62%、12%和24%、3%和11%(P=0.044),总生存率分别为73%和78%、31%和32%、20%和21%(P=0.308).CRT组和CCT组副反应无差异(P＞0.05).结论 局部晚期NSCLC患者同时放化疗后巩固性化疗的无进展生存率有所提高而总生存率相似,且两组毒副反应无差别,但是否真正受益有待进一步多中心和扩大病例数研究.
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