同步放化疗联合中药健脾补肾法治疗局部晚期非小细胞肺癌临床研究

摘要

目的 探讨同步放化疗联合中药健脾补肾法治疗局部晚期非小细胞肺癌的疗效.方法 126例局部晚期非小细胞肺癌患者,随机分为治疗组(同步放化疗联合中药健脾补肾)和对照组(同步放化疗).治疗组68例(Ⅲa期28例,Ⅲb期40例),放疗开始紫杉醇135 mg/m2静滴d1,顺铂60 mg/m2静滴d3,每21～28天重复.放疗结束后给予原方案化疗.共化疗4周期.在化疗结束时口服健脾补肾中药三胶扶正合剂每天250 mL,放化疗结束后每日口服250 mL至疾病进展.对照组放化疗方案均与治疗组相同.结果 全部病例随访5年以上,随访率95.24%.临床症状改善率治疗组为80.88%(55/68),对照组为65.5%(38/58),两组比较差异有统计学意义(χ2=3.82,P<0.05).治疗组3、5年生存率分别为49.52%、21.49%,中位生存时间(MST)22个月;对照组3、5年生存率分别为36.73%、15.14%,中位生存时间(MST)17个月;两组比较差异有统计学意义(χ2=4.94,P<0.05;χ2=5.94,P<0.05).两组生存曲线比较差异有统计学意义(χ2=5.18,P<0.05).治疗组Ⅲ～Ⅳ度白细胞下降的发生率20.59%低于对照组的72.41%,两组比较差异有统计学意义(χ2=31.3,P<0.05).治疗组放射性食管炎、放射性肺炎发生率分别为30.88%(21/68)、13.23%(9/68),低于对照组的发生率,两组比较差异有统计学意义(χ2=8.38和10.13,P<0.05).结论 同步放化疗联合健脾补肾中医药治疗局部晚期非小细胞肺癌,近期疗效、临床症状改善、3、5年远期生存率较单纯同步放化疗提高,毒性下降.%Objective To observe the effect and side efects of concurrent chemoradiotherapy for concurrent chemoradiotherap combination Chinese medicine to invigorate the spleen and the kidney for locally advanced non-small cell lung cancer.Methods 126 patients were randomly allocated into 2 groups.The therapy group( concurrent chemoradiotherapy combination Chinese medicine) ens 68 patients( Ⅲ a stage 28 cases, Ⅲ b stage 40 cases) ,the radiotherapy and chemotherapy was carried out the same as the Concurrent chemoradiotherap group,i. e.firstly with pacjitaxel l35mg/m2 iv dl , cisplatin 60mg/m2 iv d3, repeated every 28 days, total 4cycle.After the chemotherapy to end take orally Sanjiao Fuzheng Heji 250ml once daily, when the disease progress to stop take orally Sanjiao Fuzheng Heji.Results All patients were followedup for more than five years.The followed-up rate was 95.24％.In the therapy group,the 3-year survival rate and the 5-year survival rate were 49.52％ and 21.49％ , MST 22 months.In the concurrent chemoradiotherapy group the 3-year survival rate and the 5-year survival rate were 36.73％ and15.14％ , MST 17 months.There was significant difference in two groups(P＜0.05 , x2 = 4.94 ; x2 = 5.94 ,P＜0.05).In the therapy group the Ⅲ - Ⅳ leucocyte decrease rate were 20.59％ ; radiation pneumonia were 13.23％ ;In the concurrent chemoradiotherapy group the Ⅲ - Ⅳ leucocyte decrease rate were 72.41％ ; radiation pneumonia were 13.23％ ; radiation esophagitis were 30.88％.There was significant difference in two groups(P＜0.05).Conclusion Concurrent Chemoradiotherapy combination Chinese medicine for advanced locally advanced non-small cell lung cancer can significantly improve the 3-year and 5-year survival rate and has degrade in toxicityside effect.