目的：探讨化疗联合全身热疗对Ⅳ期非小细胞肺癌患者的治疗效果。方法：对37例ECOG-PS评分为0-2分的Ⅳ期非小细胞肺癌患者进行化疗联合全身热疗治疗，与同期35例单纯化疗患者比较疗效。化疗方案采用含铂类（顺铂或卡铂）方案：TP（紫杉醇＋顺铂或卡铂）方案、NP（长春瑞滨＋顺铂或卡铂）方案。全身热疗采用上海华源WB-Ⅰ型全身热疗系统进行治疗，每个周期化疗第1天开始，同时进行热疗，1次/天，每次时长40-60min，直肠温度38℃-39．5℃，8-10次/周期，每化疗2个周期后进行疗效评价，进展的患者改用未用过的二线化疗方案，总疗程6个周期，观察12个月。结果：实验组与对照组有效率、症状缓解率、1年生存率分别为：59．4％和40．0％、75．7％和60．0％、48．6％和37．1％（P＜0．05）。两组毒副反应主要为胃肠道反应和骨髓抑制，胃肠道反应0-Ⅱ度33例和30例，Ⅲ度4例和5例；骨髓抑制0-Ⅱ度29例和28例，Ⅲ度8例和7例（P＞0．05）。经过相应的药物治疗，均能很快恢复。结论：化疗联合全身热疗治疗Ⅳ期非小细胞肺癌较单一化疗提高了疗效，不增加患者的毒副反应，是综合治疗晚期非小细胞肺癌的有效手段之一。%Objective:To explore the effect of chemotherapy in combination with systemic thermal therapy for pa-tients with stageⅣnon-small cell lung cancer.Methods:All 37 cases with non-small cell lung cancer were treated with chemotherapy in combination with the whole body hyperthermia,compared with 35 patients with chemotherapy a-lone;Plan a platinum-based chemotherapy(cisplatin or carboplatin)scheme:TP(paclitaxel+cisplatin or carbopla tin)scheme,NP(changchun marina+cisplatin or carboplatin)scheme.The whole body heat treatment,1 time/day, 40-60min,rectal temperature 38℃-39.5℃.Results:In the experimental group and control group ,effective rate , symptom remission rate,1 year survival rate were respectively:59.4% vs 40.0%,75.7% vs 60.0%,48.6% vs 37.1%(P<0.05).In two groups adverse reaction were mainly gastrointestinal reaction and bone marrow suppres-sion,gastrointestinal reaction:0-Ⅱ33 vs 30 cases,Ⅲ4 vs 5 cases;bone marrow suppression:0-Ⅱ29 vs 28 cases,Ⅲ8 vs 7 cases(P>0.05 ).Conclusion:Chemotherapy in combination with the whole body heat treatment can im-prove the curative effect,do not increase adverse reaction,is one of the effective means of comprehensive treatment of advanced NSCLC.
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