奈达铂联合紫杉醇与顺铂联合紫杉醇同步放化疗对Ⅲ期非小细胞肺癌的疗效对照研究

摘要

Objective To explore the efficacy and toxicities of nedaplatin/ cisplatin and paclitaxel combined with radiotherapy in the treatment of patiens with inoperable stage III A and stage III B non-small cell lung cancer. Methods Patients in the experimental group ( TN group,30 cases ) were treated with intravenous infusion of paclitaxel 50 mg/m2 and nedaplatin 30 mg/m for 7 cycles every week. The patients in the control group ( TP group,30 cases )were treated with cisplatin ( 30 mg/m2 dl ) intravenously instead of nedaplatin and paclitaxel as in the experimental group. Patients in both groups received the same radiotherapy, which is concurrently with the chemotherapy with a total dose of 63 Gy in 7 weeks in 34 fractions. Results After concurrent che-moradiotherapy ,the response rate in the two groups was 85.7% and 80% ( x2 = 0. 02 ,P > 0.05 ), and the difference was not statistically significant. Hematological toxicities were not significantly different in the experimental and control groups, which included leukopenia in 57. 1% ( 16/28 ) and 55. 0% ( 11/20 ), anemia in 28. 6% ( 8/28 ) and 30% ( 6/20 ), and thrombocytopenia in 39. 3%( 11/28 ) and 20. 0% ( 4/20 ). Liver damage,radiation pneumonitis,radiation esophagitis were also not significantly different in the two groups. The incidence of renal damage, nausea and vomiting, weight loss ( > 10% ) was significantly lower in the experimental group than that in the control group. Conclusion Radiotherapy combined with concurrent nedaplatin and paclitaxel is effective in the treatment of patients with stage III non-small cell lung cancer,with tolerable toxicities.%目的 探讨奈达铂替代顺铂与紫杉醇联合同步放化疗,对不能手术的ⅢA期和ⅢB期非小细胞肺癌患者的疗效及耐受性.方法 实验组(TN组)30例:采用紫杉醇50 mg/m2 ( ivgtt,d1)+奈达铂30 mg/m2 (ivgtt,d1)化疗,每周1次,同期行胸部放疗(63 Gy/7周/34次).对照组(TP组)30例:顺铂(30 mg/m2,ivttt,d1) 代替奈达铂,余治疗同实验组.结果 同步化放疗后评价疗效:实验组和对照组有效率分别为85.7%和80.0%[χ2=0.02(校正),P＞0.05],两组比较差异无统计学意义.实验组和对照组白细胞减少发生率分别为57.1% (16/28) 和55.0%(11/20)(P＞0.05),两组比较差异无统计学意义;贫血发生率分别为28.6%(8/28)和30.0%(6/20)(P＞0.05),两组比较差异无统计学意义;血小板下降发生率分别为39.3%(11/28)和20.0%(4/20)(P＞0.05),两组比较差异无统计学意义;肝功能损害,放射性肺炎和放射性食管炎发生率实验组和对照组比较差异均无统计学意义;肾功能损害发生率及恶心、呕吐发生率实验组明显低于对照组,差异有统计学意义;体重下降(>10%)发生率实验组明显低于对照组,差异有统计学意义.结论 奈达铂联合紫杉醇同步放疗对III期非小细胞肺癌的疗效确切,且患者耐受性良好.