伽马刀联合复方红豆杉胶囊治疗高龄晚期非小细胞肺癌疗效分析

摘要

目的：分析伽马刀联合复方红豆杉胶囊治疗高龄晚期非小细胞肺癌的疗效。方法：2008年1月至2011年11月期间，我院收治的高龄晚期非小细胞肺癌15例采用伽马刀治疗+复方红豆杉胶囊0.6g口服3次/日，21天为1疗程，此后每月按疗程连续口服。伽马刀治疗以50％~80％等剂量曲线为处方剂量线，平均剂量（45.1667±4.7346）Gy/（6~14）f，3.5~8Gy/f，5f/w，1f/d。治疗结束后，每1~3月复查血常规、血生化、肿瘤标志物及影像学检查。随访3~60个月至2013年9月结束。结果：局部有效率（ CR+PR）95.83％，中位生存期18个月（6~60个月），1、2、3、4、5年生存率分别为66.7％、33.3％、33.3％、6.7％、6.7％。消化道反应：I度1例、II度3例；血液学毒性：白细胞降低I度2例、II度1例，血小板降低I度1例、II度1例；放射性肺炎III级9例。结论：伽马刀联合复方红豆杉胶囊治疗高龄晚期非小细胞肺癌有效，可延长患者生存期，不良反应可接受。%Objective:To analyze the effectiveness of Gama-knife combined with Hongdoushan capsules in the treatment of elderly patients with advanced non-small cell lung cancer. Methods:From Jan. 2008 to Nov. 2011 in our hospital,15 elderly patients with advanced non-small cell lung cancer accepted the treatment of Gama-knife and Hongdoushan capsules of the dose of 0. 6g 3/d and 21 days as a course which orally administrated without stop monthly. A 30~56Gy total dose were prescribed to the 50% ~80% isodoseline and in 6~14 fraction of 3. 5~8Gy each for target with one week five times and one day one time for the Gama-knife treatment. Blood routine,blood bio-chemistry,tumor markers and imaging examinations were taken on the patients every 1~3 months after treatment. The follow-up time was 3~60 months and ended in Sep. 2013. Results:The local tumors'response rate(CR+PR)was 95. 83%. The overall survival time was 6~60 months with a median survival time of 18 months,and the 1-,2-, 3-,4-,5 -year survival rate was 66. 7%,33. 3%,33. 3%,6. 7%,and 6. 7% respectively. For digestive side effect,1 case was grade I,3 was II,for haematological toxicity,2 cases occurred grade I white cell reduction,1 was II and 1 case occurred grade I blood platelets reduction,1 was II,9 cases occurred grade III radiation pneumonitis. Con-clusion:Gama-knife combined with Hongdoushan capsules treatment is effective for elderly patients with advanced non-small cell lung cancer with an acceptable toxicity and it can prolong the patients' survival time.