目的 研究三维适形放射治疗联合紫杉醇/顺铂同步化疗治疗局部晚期非小细胞肺癌的临床疗效以及不良反应.方法 86例局部晚期非小细胞肺癌患者随机分成2组,三维适形放疗同步联合紫杉醇/顺铂治疗组以及单纯三维适形放疗组.两组放疗方法相同,放疗剂量DT60～70GY,每次2GY,每周5次,化疗方案为紫杉醇175mg/m2,静滴,第1天,顺铂30mg/m2,静滴,第1～3天,21天为1周期,于放疗的第1天即开始化疗.结果 同步放化疗组和单纯放疗组近期有效率分别为68.0％和38.1％(P＜0.05).放射性食管炎以及放射性肺炎的发生率同步组明显高于单纯放疗组(P＜0.05).结论 三维适形放疗联合紫杉醇/顺铂治疗局部晚期非小细胞肺癌的近期疗效较单纯三维适形放疗疗效好,不良反应虽有增加,但可以耐受.%Objective To evaluate the therapeutic efficacy and the radiation complication of three-dimensional con-formal radiotherapy concurrent paclitaxel and cisplatin for locally advanced non-small cell lung cancer. Methods 86 patients with locally advanced non-small cell lung cancer were randomly divided into two groups: three-dimensional conformal radiotherapy concurrent paclitaxel and cisplatin group and three-dimensional conformal radiotherapy alone group. The same radiation method was used in the two groups, 2 Gy per fraction and 5 fractions per week for a total dose of 60-70Gy. Chemotherapy consisted of paclitaxel 175mg/m2 dland cisplatin 30mg/m2 dl-3 of 21-day cycle. The concurrent group received radiotherapy on the firest day of chemotherapy. Results The response rate in the concurrent group was 68% and 38. 1% in the only three-dimensional conformal radiotherapy group (P<0. 05). The acute toxic effects such as radiation esophagitis and radiation pneumonitis were more severe in the concurrent group than in the radiation alone group (P<0. 05). Conclusion Concurrent radiotherapy and chemotherapy with paclitaxel and cisplatin is an effective regimen for locally advanced non-small cell lung cancer.
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