加速超分割放疗联合化疗治疗局限期小细胞肺癌的疗效分析

摘要

Objective To explore the efficacy and safety of accelerated hyperlractionation radiotherapy combined with EP regimen on limited small cell lung cancer. Methods 72 patients were randomized into two groups : 35 patients in accelerated hyperfractionation radiotherapy ( HART ) group , 37 patients in conventional iractionation radiotherapy ( CFRT ) group. Results The total effective rate( PR + CR ) in HART group and in CFRT group were 82. 8% and 59. 4% . The 1 , 2, and 3 year survival rates in HART and CFRT were 90. 1% vs 83. 1%,55. 2% vs43. 8% and 25.4% vs 17. 6%( P <0. 05 ). The main adverse events were leukopenia and radiation esophagitis, which were significantly higher in HART group than those in CFRT group( P <0. 05 ), but they could be tolerated. Conclusions This study suggests that EP regimen combined accelerated hyperlractionation radiotherapy was more effective and well tolerated. It should be further studied.%目的 探讨加速超分割胸腔放疗联合EP方案治疗局限期小细胞肺癌的疗效及安全性.方法 共72例局限期小细胞肺癌随机分为加速超分割组和常规分割组,其中加速超分割组放疗1.5 Gy/次,2次/日,间隔6小时,总量45Gy;常规分割组1.8~2 Gy/次,1次/日,总量50 Gy.两组全部采用EP方案化疗4~6周期.结果 加速超分割组与常规分割组的有效率分别为82.8%和59.4%(P＜0.05),加速超分割组与常规分割组的1年、2年和3年生存率分别为90.7% vs 83.1%、55.2% vs 43.8%和25.4% vs 17.6%(P＜0.05).主要毒性反应为白细胞减少和放射性食管炎,超分割组的白细胞减少与放射性食管炎较常规分割组有所升高(P＜0.05),但均可耐受.结论 加速超分割放疗联合EP方案化疗提高了局限期小细胞肺癌的疗效,同时增加了骨髓抑制、放射性食管炎等急性放射性损伤,但是毒性反应可以耐受,值得进一步推广应用.