CAJ | 학술논문

目的探讨紫杉醇脂质体联合顺铂同步放疗治疗局部晚期非小细胞肺癌（NSCLC）的疗效和毒副反应。方法36例患者行常规分割放疗40Gy，针对局部病灶行三维适形放疗（3DCRT）加量至中位总剂量达68Gy/34次（66-70Gy/33-35次）。化疗方案为紫杉醇脂质体135mg/m2静脉滴注第1天，顺铂（诺欣）20mg/(m2静脉滴注，第1-4天。结果全组36例均可评价疗效，总有效率(CR+PR)为69.4%。中位缓解期为9.2个月,中位生存期为14.8个月，1年、2年的生存率分别为66.7%和44.4%。主要毒性反应为白细胞减少Ⅲ度17例(47.2%)，Ⅳ度3例(8.3%)。急性放射性肺炎1-2级14例（38.9%）；急性放射性食管炎1-2级17例（47.2%），3级2例（5.6%）。结论紫杉醇脂质体加顺铂同步放化疗治疗局部晚期NSCLC局控率较高，骨髓毒副反应较明显，急性放射性损伤大多数患者尚可耐受。
목적탐토자삼순지질체연합순박동보방료치료국부만기비소세포폐암（NSCLC）적료효화독부반응。방법36례환자행상규분할방료40Gy，침대국부병조행삼유괄형방료（3DCRT）가량지중위총제량체68Gy/34차（66-70Gy/33-35차）。화료방안위자삼순지질체135mg/m2정맥적주제1천，순박（낙흔）20mg/(m2정맥적주，제1-4천。결과전조36례균가평개료효，총유효솔(CR+PR)위69.4%。중위완해기위9.2개월,중위생존기위14.8개월，1년、2년적생존솔분별위66.7%화44.4%。주요독성반응위백세포감소Ⅲ도17례(47.2%)，Ⅳ도3례(8.3%)。급성방사성폐염1-2급14례（38.9%）；급성방사성식관염1-2급17례（47.2%），3급2례（5.6%）。결론자삼순지질체가순박동보방화료치료국부만기NSCLC국공솔교고，골수독부반응교명현，급성방사성손상대다수환자상가내수。
Objective: To evaluate the acute side effects and clinical efficacy of paclitaxel liposome plus cisplatin(DDP) combined with concurrent chemo-radiotherapy for local y advanced non smal cel cancer. Methods: The first conventional fractionation radiotherapy 36 patiets were treated to the total dose of 40Gy.The second 3DCRT the primary tumor bed were treated to the total dose of 28~36Gy.paclitaxel liposome135mg/ m2 by intravenous infusion on day1, and DDP 20mg/ m2 by intravenous infusion on day 1-4. Results: The response rate(RR) was 69.4%.Median TTP was 9.2 months,median overal survival time was 14.8 months,and the 1-year,2-year overal survival time was 66.7% and 44.4%.16 patients had radiation pneumonitis Ⅰ-Ⅱ degree. 17 patients had radiation esophagitis,3 patients had Ⅲ degree.Conclusion: Paclitaxel liposome plus cisplatin(DDP) combined with concurrent chemo-radiotherapy for local y advanc local y advance NSCLC with good immediate tumor response and acceptable normal tissue complication.