中国医药
中國醫藥
중국의약
CHINA MEDICINE
2012年
3期
283-285
,共3页
张薇%李莎%魏世华%岳养军%田种泽%朱向辉
張薇%李莎%魏世華%嶽養軍%田種澤%硃嚮輝
장미%리사%위세화%악양군%전충택%주향휘
癌,非小细胞肺%三维适形放射治疗%放射疗法%化学疗法%放射性肺炎
癌,非小細胞肺%三維適形放射治療%放射療法%化學療法%放射性肺炎
암,비소세포폐%삼유괄형방사치료%방사요법%화학요법%방사성폐염
Carcinoma,non-small cell lung%Three dimensional conformal radiation therapy%Radiotherapy%Chemotherapy%Radiation pneumonitis
目的 探讨以顺铂为基础的不同化疗方案同步三维适形放射治疗局部晚期非小细胞肺癌(NSCLC)对放射性肺炎的影响.方法 回顾性分析120例局部晚期NSCLC,所有患者均接受了以顺铂为基础的联合化疗同步三维适形放射治疗,按化疗方案的不同分为EP(顺铂和足叶乙苷)方案组(57例)、NC(顺铂和多西他赛)方案组(41例)和DC(顺铂和长春瑞滨)方案组(22例),观察3组放射性肺炎的发生、转归及其影响因素.结果 1+2级放射性肺炎EP方案组为33.3％( 19/57),NC方案组为29.3％( 12/41),高于DC方案组[22.7％(5/22)]；≥3级放射性肺炎发生率EP方案组为10.5％(6/57),NC方案组为9.7％(4/41),DC方案组为4.5％ (1/22)；但是3组在发生放射性肺炎级别程度上差异无统计学意义(P＞0.05),经治疗后3组发生放射性肺炎患者的转归差异无统计学意义(P＞0.05).结论 以顺铂为基础的化疗方案同步三维适形放射治疗局部晚期NSCLC发生放射性肺炎是可以耐受的,接受顺铂和多西他赛、足叶乙苷、长春瑞滨联合化疗对放射性肺炎影响的差异无统计学意义.但多西他赛能提高肺的耐受性,具有较强的放射增敏效应,对于老年且合并慢性阻塞性肺疾病的患者可考虑优先多西他赛化疗,以减少放射性肺炎的发生.
目的 探討以順鉑為基礎的不同化療方案同步三維適形放射治療跼部晚期非小細胞肺癌(NSCLC)對放射性肺炎的影響.方法 迴顧性分析120例跼部晚期NSCLC,所有患者均接受瞭以順鉑為基礎的聯閤化療同步三維適形放射治療,按化療方案的不同分為EP(順鉑和足葉乙苷)方案組(57例)、NC(順鉑和多西他賽)方案組(41例)和DC(順鉑和長春瑞濱)方案組(22例),觀察3組放射性肺炎的髮生、轉歸及其影響因素.結果 1+2級放射性肺炎EP方案組為33.3％( 19/57),NC方案組為29.3％( 12/41),高于DC方案組[22.7％(5/22)]；≥3級放射性肺炎髮生率EP方案組為10.5％(6/57),NC方案組為9.7％(4/41),DC方案組為4.5％ (1/22)；但是3組在髮生放射性肺炎級彆程度上差異無統計學意義(P＞0.05),經治療後3組髮生放射性肺炎患者的轉歸差異無統計學意義(P＞0.05).結論 以順鉑為基礎的化療方案同步三維適形放射治療跼部晚期NSCLC髮生放射性肺炎是可以耐受的,接受順鉑和多西他賽、足葉乙苷、長春瑞濱聯閤化療對放射性肺炎影響的差異無統計學意義.但多西他賽能提高肺的耐受性,具有較彊的放射增敏效應,對于老年且閤併慢性阻塞性肺疾病的患者可攷慮優先多西他賽化療,以減少放射性肺炎的髮生.
목적 탐토이순박위기출적불동화료방안동보삼유괄형방사치료국부만기비소세포폐암(NSCLC)대방사성폐염적영향.방법 회고성분석120례국부만기NSCLC,소유환자균접수료이순박위기출적연합화료동보삼유괄형방사치료,안화료방안적불동분위EP(순박화족협을감)방안조(57례)、NC(순박화다서타새)방안조(41례)화DC(순박화장춘서빈)방안조(22례),관찰3조방사성폐염적발생、전귀급기영향인소.결과 1+2급방사성폐염EP방안조위33.3％( 19/57),NC방안조위29.3％( 12/41),고우DC방안조[22.7％(5/22)]；≥3급방사성폐염발생솔EP방안조위10.5％(6/57),NC방안조위9.7％(4/41),DC방안조위4.5％ (1/22)；단시3조재발생방사성폐염급별정도상차이무통계학의의(P＞0.05),경치료후3조발생방사성폐염환자적전귀차이무통계학의의(P＞0.05).결론 이순박위기출적화료방안동보삼유괄형방사치료국부만기NSCLC발생방사성폐염시가이내수적,접수순박화다서타새、족협을감、장춘서빈연합화료대방사성폐염영향적차이무통계학의의.단다서타새능제고폐적내수성,구유교강적방사증민효응,대우노년차합병만성조새성폐질병적환자가고필우선다서타새화료,이감소방사성폐염적발생.
Objective To investigate the effects of radiation pneumonitis in different cisplatin-based concurrent chemotherapy regimens and three-dimensional conformal radiation therapy (3D-CRT)for locally advanced non-small cell lung cancer(NSCLC).Methods A retrospective analysis of 120 cases with locally advanced nonsmall cell lung cancer was conducted.All patients were treated with cisplatin-based concurrent chemotherapy and three-dimensional conformal radiation therapy and randomly divided into EP( etoposide + cisplatin)regimen group (57 cases),NC( vinorelbine + cisplatin) regimen group(41 cases) and DC( docetaxel + cisplatin) regimen group(22 cases).The occurrence,prognosis and influencing factors of radiation pneumonitis were observed.Results The incidence of 1 and 2 grade radiation pneumonitis was 33.3％ ( 19/57 )in EP regimen group,29.3％ ( 12/41 )in NC regimen group and 22.7％ (5/22) in DC regimen group.3 and 4 grade radioactive pneumonia was 10.5％ (6/57),9.7％ (4/41),4.5％ ( 1/22 ) respectively.The differences of levels of radiation pneumonitis in three group were not statistically significant( P ＞ 0.05 ).Conclusions The radiation pneumonitis in cisplatin-based concurrent chemotherapy and three-dimensional conformal radiation therapy for locally advanced NSCLC are tolerable.The differences of cisplatin plus docetaxel,etoposide or vinorelbine combination chemotherapy are not statistically significant.Docetaxel is more sensitive to radiation than to etoposide and vinorelbine.It is suggested that old patients with chronic bronchitis should first have 3DCRT combined with DC chemotherapy.
