目的：探讨老年局部晚期非小细胞肺癌（ NSCLC）患者序贯放化疗和同期放化疗的临床疗效、不良反应及对生活质量的影响。方法60例患者随机分为序贯组和同期组，每组各30例。两组放射治疗和药物化疗均采用相同的方案。序贯组先行化疗，化疗结束后，再予以放射治疗；同期组在化疗的第一个周期就同步进行放射治疗。观察两组近期疗效、不良反应及治疗前后生存质量各维度评分。结果同期组近期疗效有效率56．67％（17／30），显著高于序贯组的26．67％（8／30）（P＜0．05），同期组白细胞减少、中性粒细胞减少等不良反应发生率高于序贯组（P＜0．01），经支持治疗，未出现死亡病例。治疗后，同期组FACT－L各维度评分显著高于治疗前（ P＜0．05或P＜0．01），且均显著高于序贯组（ P＜0．05或P＜0．01）。结论同期放化疗可有效提升老年局部晚期非小细胞肺癌的近期疗效，提高生存质量，虽不良反应发生率高于序贯组，但经积极治疗未出现死亡病例，值得临床推广。%Objectives To investigate the clinical efficacy and adverse reactions of concurrent chemoradiotherapy versus sequen -tial chemoradiotherapy and their influence on the quality of life ( QOL) in elderly patients with locally advanced non-small cell lung cancer (NSCLC).Methods A total of 60 patients were randomly divided into sequential group (n=30) and concurrent group (n=30).The radiotherapy and chemotherapy protocols were same for two groups .Sequential group was given chemotherapy first and then radiotherapy after completion of it .Concurrent group was conducted with concurrent chemotherapy and radiotherapy starting from the first cycle of treatment .The efficacy ,adverse reactions and QOL scores were observed before and after treatment .Results The effective rate was 56.67%(17/30) in concurrent group,significantly higher than the 26.67%(8/30) in sequential group (P<0.05).The incidence rates of leucopenia and neutropenia in concurrent group were obviously higher than those in sequential group (P<0.01),but no death occurred after supportive treatment .Moreover,the FACT-L scores in concurrent group after treatment were higher than those before treatment ,and were also higher than those in sequential group (P<0.05 or P<0.01).Conclusions Con-current chemoradiotherapy can improve the short-term efficacy and QOL of patients with elderly patients with locally advanced NSCLC.Although the incidence rate of adverse reactions is higher than that in sequential group ,no death occurred after supportive treatment,so it is worth clinical promotion .
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