CAJ | 학술논문

目的：探讨多西他赛、顺铂化疗联合同步放疗治疗Ⅲ期非小细胞肺癌（ NSCLC）的临床疗效及安全性。方法入选Ⅲ期NSCLC患者20例为研究对象。患者入组后，第1天，静脉滴注多西他赛20 mg? m－2，顺铂30 mg? m－2。在放射治疗开始时同步进行化疗，每周1次，共3周；放疗剂量为每次2 Gy，每周5次，总剂量为30 Gy。放疗结束后2周进行NSCLC临床分期评估和手术治疗。评价患者的临床缓解率、手术切除率及术后生存时间。结果20例患者中完成3周期的化疗和30 Gy放疗者18例，18例患者中完全缓解2例，部分缓解6例，稳定8例，进展2例，客观缓解率44．4％。11例患者接受了手术治疗，手术完整切除者9例，1例患者肿瘤与侵犯大血管，1例发生广泛胸膜转移未能手术切除，手术切除率为81．8％。患者的中位生存时间为18．5个月，其中，新辅助放化疗后接受手术治疗组中位生存时间为22．5个月，未能接受手术组为10．1个月；手术组中位生存时间显著高于未手术组（ P＜0．05）。2例患者放化疗过程中出现严重不良反应而退出本研究。结论多西他赛顺铂方案联合同步放疗可提高Ⅲ期非小细胞肺癌手术切除率。
목적：탐토다서타새、순박화료연합동보방료치료Ⅲ기비소세포폐암（ NSCLC）적림상료효급안전성。방법입선Ⅲ기NSCLC환자20례위연구대상。환자입조후，제1천，정맥적주다서타새20 mg? m－2，순박30 mg? m－2。재방사치료개시시동보진행화료，매주1차，공3주；방료제량위매차2 Gy，매주5차，총제량위30 Gy。방료결속후2주진행NSCLC림상분기평고화수술치료。평개환자적림상완해솔、수술절제솔급술후생존시간。결과20례환자중완성3주기적화료화30 Gy방료자18례，18례환자중완전완해2례，부분완해6례，은정8례，진전2례，객관완해솔44．4％。11례환자접수료수술치료，수술완정절제자9례，1례환자종류여침범대혈관，1례발생엄범흉막전이미능수술절제，수술절제솔위81．8％。환자적중위생존시간위18．5개월，기중，신보조방화료후접수수술치료조중위생존시간위22．5개월，미능접수수술조위10．1개월；수술조중위생존시간현저고우미수술조（ P＜0．05）。2례환자방화료과정중출현엄중불량반응이퇴출본연구。결론다서타새순박방안연합동보방료가제고Ⅲ기비소세포폐암수술절제솔。
Objective To investigate the clinical effects of docetaxel plus cisplatin combined with concurrent radiation in the treatment of stageⅢ non-small cell lung cancer ( NSCLC ) .Methods Twenty patients with stageⅢNSCLC were recruited.Patients were treated with docetaxel 20 mg? m-2 intravenous drop infusion plus cisplatin 30 mg? m-2 intravenous drop infusion on day 1.At the same time, the patients also received radiation with 2 Gy qd for 5 times per week with the total dosage of 30 Gy.Two weeks after the chemoradiation, patients received the clinical stage evaluation and surgery. The clinical efficacy, surgical resection rate and survival time were evaluated.Results Eighteen cases finished the 3 cycle chemoradiation. For the 18 subjects, 2 cases achieved complete response, 6 achieved partial response, 2 achieved sta-ble disease and 2 achieved progress disease with the objective response rate of 44.4%.Of the 18 cases, 11 patients received operation, with the completed removal rate of 81.8%, two patients with pleural metastasis or tumor invasion of the large vessel were not given complete removal.The median survivals were 22.5 months and 10.1 months in the operation group and non-operation group with statistical difference( P<0.05).Two cases drop out of the trial for severe adverse event.Conclusion Docetaxel plus cisplatin combined with concurrent radiation can improve the operation rate for stage Ⅲnon-small cell lung cancer.