紫杉醇顺铂方案联合同步放疗治疗顺铂依托泊苷化疗不敏感局限期小细胞肺癌的临床疗效

摘要

Objective To study clinical efficacy of paclitaxel and cisplatin chemotherapy with synchronous radiotherapy to local stage small cell lung cancer patients who were not sensitive to two cycles of chemotherapy with cisplatin.Methods Patients who had no change(SD) or progressive disease(PD) were divided into group A and B after two cycles of chemotherapy with cisplatin and etoposide.There were sixteen patients in group A,and seventeen in group B,respectively.No differences were observed in the gender and age between group A and group B.Patients in group A were continuously given cisplatin and etoposide chemotherapy with synchronous radiotherapy,and in B group changed to giving paclitaxel and cisplatin chemotherapy with synchronous radiotherapy.The side effects were recorded when or after chemo-therapy with synchronous radiotherapy.The short-term responsiveness and progression-free survival(PFS) of these patients were assessed by follow-up.Results The response rate(CR+PR)of group A was 37.5%(6/16),which was higher than that of group B[76.5%(13/17)](χ2=5.125,P=0.037).The median PFS of group A was 6.0 months,which was higher than that of group B(12.0 months)(χ2=5.134,P=0.023).The adverse reactions(such as bone marrow suppression,radioactive esophagitis and radiation pneumonitis)between two groups had no statistical differences.Conclusions Paclitaxel and cisplatin chemotherapy with synchronous radiotherapy is a safe and effective treatment for local stage small cell lung cancer patients who are not sensitive to cisplatin and etoposide chemotherapy.%目的 探讨紫杉醇顺铂联合同步放疗对顺铂依托泊苷(EP)不敏感局限期小细胞肺癌的治疗作用.方法 EP两周期化疗结束2 w后评估为无变化和疾病进展的患者为研究对象,在知情同意下随机分为继用EP方案化疗联合同步放疗组(观察组)和改用紫杉醇顺铂联合同步放疗组(对照组).观察两组的毒副作用,评估治疗结束后4 w的近期临床有效率(RR),以疾病无进展生存时间(PFS)为随访终点.结果 观察组的RR 为37.5%(6/16),对照组为76.5%(13/17),两组差异显著.中位PFS:观察组为6.0个月,对照组为12.0个月,两组差异显著.两组骨髓抑制、放射性食管炎及放射性肺炎等不良反应无统计学差异.结论 紫杉醇顺铂联合同步放疗对EP两周期化疗不敏感局限期小细胞肺癌有效.