CAJ | 학술논문

目的：观察NP方案化疗序贯立体定向放射治疗IIIB非小细胞肺癌的效果。方法34例IIIB期非小细胞肺癌患者在接受立体定向放射治疗前完成1次NP方案化疗，然后接受立体定向放射治疗，照射剂量60～64 Gy/6～7W，放射治疗后再完成1～3次NP方案化疗。在完成放射治疗后1个月开始定期复查胸部CT，随访3年。结果全组患者均完成立体定向放射治疗计划，共完成化疗104个周期。全组患者CR 12例，PR 17例，SD 2例，PD 3例，有效率达85％。34例患者中位无进展生存期6．7个月，生存期（按照随访时间计算）7～36个月，中位生存期18．1个月，其中1年生存率82％（28例存活，2例死于脑梗死，1例死于肺心病，其余3例死于肿瘤进展），2年生存率63％，3年生存率36％。相关毒性多在Ⅰ～Ⅱ级。结论 NP方案化疗序贯立体定向放射治疗IIIB期非小细胞肺癌，可以获得较好的疗效，毒性反应轻微，易于执行，值得临床推广。
목적：관찰NP방안화료서관입체정향방사치료IIIB비소세포폐암적효과。방법34례IIIB기비소세포폐암환자재접수입체정향방사치료전완성1차NP방안화료，연후접수입체정향방사치료，조사제량60～64 Gy/6～7W，방사치료후재완성1～3차NP방안화료。재완성방사치료후1개월개시정기복사흉부CT，수방3년。결과전조환자균완성입체정향방사치료계화，공완성화료104개주기。전조환자CR 12례，PR 17례，SD 2례，PD 3례，유효솔체85％。34례환자중위무진전생존기6．7개월，생존기（안조수방시간계산）7～36개월，중위생존기18．1개월，기중1년생존솔82％（28례존활，2례사우뇌경사，1례사우폐심병，기여3례사우종류진전），2년생존솔63％，3년생존솔36％。상관독성다재Ⅰ～Ⅱ급。결론 NP방안화료서관입체정향방사치료IIIB기비소세포폐암，가이획득교호적료효，독성반응경미，역우집행，치득림상추엄。
Objective To observe the sequential therapy NP regimen and stereotatic radiotherapy for stage IIIB non-small cell lung cancer (NSCLC).Methods Thirty-four patients on stage IIIB NSCLC accepted one NP regimen chemotherapy and then were treated by 3-DCRT.The radiation dose raged from 60-64Gy/6-7 weeks.1-3 NP regimen chemotherapy was completed after radiotherapy.The lung CT was regularly reviewed one month after radiotherapy and the patients received 3 years of follow-up.Results All patients completed 3-DCRT and 104 cycles of chemotherapy.In 34 patients,there were 12 CR (complete response),17 PR (partial response),2 SD (stable disease)and 3 PD (progressive disease).The clinical benefit rate (CR+PR+SD)was 85%.In 34 patients,the median progression free survival time was 6.7 months,the survival time (survivors according to follow-up time)was 7-36 months and the median survival time was 18.1 months. Among them,one-year survival rate was 82% (28 cases survived,2 cases died of cerebral infarction,1 case died of pulmonary heart dis-ease,and 3 cases died of tumor progression).In two years,there were 15 survivors and the survival rate was 63%.There were 5 survivors over 3 years and the survival rate was 36%.All patients received 3-DCRT again and the related toxicity was mostly in gradeⅠand II.Con-clusion The efficacy on NP regimen combined with sequential stereotatic radiotherapy for Stage Ⅲnon-small cell lung cancer is preferable. The toxicity is mild.It is ease to implement and thus worth clinical promotion.