局部晚期非小细胞肺癌同期放化疗和序贯放化疗的临床疗效比较

摘要

Objective :To compare the effect and clinical toxicity of concurrent and sequential chemoradiotherapy ( CRT ) with gemcitabine and cisplatin in stage Ⅲ non - small cell lung cancer( NSCLC ) patients. Methods: Total of 58 patients with stage Ⅲ NSCLC were randomly assigned into two groups. Sequential CRT group :accepted 4 cycles chemotherapy before radiotherapy. Concurrent CRT group :when the radiotherapy started, chemotherapy started on the 1,4,8,12 week. Method of radiotherapy was 3 - D conformal radiation therapy( 3D - CRT ). Medicine of chemotherapy was gemicitabine and cisplatin.Results: The overall response rate was 75.9％ in concurrent CRT group , and 48.3％ in sequential CRT group, difference was significant between two groups( P ＜ 0.05 ). The disease control rate in concurrent CRT group was 93.1％ , and 72.4 ％ in sequential CRT group( P ＜ 0.05 ). There was difference in myelosuppression, 100.0％ in concurrent CRT group and 79.3％ in sequential CRT group( P ＜0.05 ). Conclusion: Concurrent chemoradiotherapy has better overall respose than sequential chemoradiotherapy.%目的:比较局部晚期非小细胞肺癌同期与序贯放化疗治疗局部晚期非小细胞肺癌(NSCLC)的疗效和不良反应.方法:58例Ⅲa期和Ⅲb期NSCLC患者随机分为两组.序贯组在化疗4个周期结束后行放疗.同期组于放疗开始第1,4,8,12周给予化疗.两组病例均采用三维立体适形放疗,GP方案(吉西他滨+顺铂)化疗.结果:同期组和序贯组的有效率分别为75.9%和48.3%,两组比较差异有显著性(P<0.05).在疾病控制率方面,同期组为93.1%,序贯组为72.4%,两组比较有显著性差异(P<0.05).两组患者的血液学不良反应,同期组发生率为100.0%,序贯组为79.3%,两组间存在统计学差异(P<0.05).结论:同期组的近期疗效较序贯组存在明显优势.