中华肿瘤杂志
中華腫瘤雜誌
중화종류잡지
Chinese Journal of Oncology
2015年
11期
863-867
,共5页
刘俪玭%王小震%吉喆%王静波%毕楠%惠周光%吕纪马%梁军%周宗玫
劉儷玭%王小震%吉喆%王靜波%畢楠%惠週光%呂紀馬%樑軍%週宗玫
류려빈%왕소진%길철%왕정파%필남%혜주광%려기마%량군%주종매
癌,非小细胞肺%放射疗法%药物疗法%治疗结果%预后
癌,非小細胞肺%放射療法%藥物療法%治療結果%預後
암,비소세포폐%방사요법%약물요법%치료결과%예후
Carcinoma,non-small-cell lung%Radiotherapy%Drug therapy%Treatment outcome%Prognosis
目的 评价局部晚期非小细胞肺癌(NSCLC)患者同步放化疗的疗效和不良反应.方法 2001年1月至2010年12月间初治接受同步放化疗的251例局部晚期NSCLC患者,其中ⅢA期76例,ⅢB期175例.放疗中位剂量为60 Gy,其中调强放疗(IMRT)174例,三维适形放疗51例,常规放疗26例.全组患者接受EP方案化疗112例,接受PC方案化疗99例,接受拓扑替康单药化疗18例,接受其他方案化疗22例.分析同步放化疗的疗效及不良反应.结果 全组有244例患者可评价近期疗效,其中完全缓解6例(2.5%),部分缓解183例(75.0%),疾病稳定42例(17.2%),疾病进展13例(5.3%).全组患者中位随访时间20个月,中位生存时间为21个月,其1、3、5年生存率分别为69.2%、31.2%和23.2%.全组患者中位无进展生存时间为10个月,其1、3、5年无进展生存率分别为40.9%、22.1%和17.7%.ⅢA期和ⅢB期NSCLC患者的5年生存率分别为29.2%和20.7%,差异无统计学意义(P=0.133).全组有244例患者可评价治疗失败模式,其中61例(25.0%)出现局部区域进展,55例(22.5%)出现远处转移,77例(31.6%)出现局部区域进展和远处转移.≥3级放射性肺炎、放射性食管炎及白细胞减少的发生率分别为4.4%、11.2%和26.7%.结论 局部晚期NSCLC同步放化疗的疗效较好,不良反应患者可耐受.同步放化疗是不可手术的局部晚期NSCLC的标准治疗方法.
目的 評價跼部晚期非小細胞肺癌(NSCLC)患者同步放化療的療效和不良反應.方法 2001年1月至2010年12月間初治接受同步放化療的251例跼部晚期NSCLC患者,其中ⅢA期76例,ⅢB期175例.放療中位劑量為60 Gy,其中調彊放療(IMRT)174例,三維適形放療51例,常規放療26例.全組患者接受EP方案化療112例,接受PC方案化療99例,接受拓撲替康單藥化療18例,接受其他方案化療22例.分析同步放化療的療效及不良反應.結果 全組有244例患者可評價近期療效,其中完全緩解6例(2.5%),部分緩解183例(75.0%),疾病穩定42例(17.2%),疾病進展13例(5.3%).全組患者中位隨訪時間20箇月,中位生存時間為21箇月,其1、3、5年生存率分彆為69.2%、31.2%和23.2%.全組患者中位無進展生存時間為10箇月,其1、3、5年無進展生存率分彆為40.9%、22.1%和17.7%.ⅢA期和ⅢB期NSCLC患者的5年生存率分彆為29.2%和20.7%,差異無統計學意義(P=0.133).全組有244例患者可評價治療失敗模式,其中61例(25.0%)齣現跼部區域進展,55例(22.5%)齣現遠處轉移,77例(31.6%)齣現跼部區域進展和遠處轉移.≥3級放射性肺炎、放射性食管炎及白細胞減少的髮生率分彆為4.4%、11.2%和26.7%.結論 跼部晚期NSCLC同步放化療的療效較好,不良反應患者可耐受.同步放化療是不可手術的跼部晚期NSCLC的標準治療方法.
목적 평개국부만기비소세포폐암(NSCLC)환자동보방화료적료효화불량반응.방법 2001년1월지2010년12월간초치접수동보방화료적251례국부만기NSCLC환자,기중ⅢA기76례,ⅢB기175례.방료중위제량위60 Gy,기중조강방료(IMRT)174례,삼유괄형방료51례,상규방료26례.전조환자접수EP방안화료112례,접수PC방안화료99례,접수탁복체강단약화료18례,접수기타방안화료22례.분석동보방화료적료효급불량반응.결과 전조유244례환자가평개근기료효,기중완전완해6례(2.5%),부분완해183례(75.0%),질병은정42례(17.2%),질병진전13례(5.3%).전조환자중위수방시간20개월,중위생존시간위21개월,기1、3、5년생존솔분별위69.2%、31.2%화23.2%.전조환자중위무진전생존시간위10개월,기1、3、5년무진전생존솔분별위40.9%、22.1%화17.7%.ⅢA기화ⅢB기NSCLC환자적5년생존솔분별위29.2%화20.7%,차이무통계학의의(P=0.133).전조유244례환자가평개치료실패모식,기중61례(25.0%)출현국부구역진전,55례(22.5%)출현원처전이,77례(31.6%)출현국부구역진전화원처전이.≥3급방사성폐염、방사성식관염급백세포감소적발생솔분별위4.4%、11.2%화26.7%.결론 국부만기NSCLC동보방화료적료효교호,불량반응환자가내수.동보방화료시불가수술적국부만기NSCLC적표준치료방법.
Objective To analyze the efficacy and toxicity of concurrent chemoradiotherapy (CCRT) for patients with locally advanced non-small-cell lung cancer (LA-NSCLC).Methods Clinical data of 251 patients with stage Ⅲ (76 Ⅲ A and 175 Ⅲ B) NSCLC who received CCRT as initial treatment between Jan 2001 and Dec 2010 in our hospital were reviewed.A median total radiotherapy dose of 60 Gy (range, 50-74 Gy) were delivered.174 patients were treated with IMRT, 51 with 3D-CRT and 26 with 2D-radiotherapy.EP chemotherapy regimen was administered in 112 patients, PC regimen in 99 patients, topotecan regimen in 18 patients and other regimens in the remaining 22 patients.The efficacy and toxicity of CCRT were retrospectively analyzed.Results 244 patients were assessable for response, including 6(2.5%) patients with CR, 183(75.0%) with PR, 42 (17.2%) with SD and 13 (5.3%) with PD.At a median follow-up period of 20 months, the 1-, 3-, 5-year OS were 69.2%, 31.2%, 23.2%, respectively, and the median OS was 21 months.The 1-, 3-, 5-year PFS were 40.9%, 22.1%, 17.7%, respectively, and the median PFS was 10 months.Patients with stage Ⅲ A NSCLC achieved better 5-year OS than that with Ⅲ B NSCLC (29.2% vs.20.7%, x2=2.254, P =0.133).Failure pattern was assessable in 244 patients, including 61 (25.0%) locoregional progression alone, 55 (22.5%) distant metastasis alone and 77 (31.6%) with both.The rates of grade ≥ 3 radiation pneumonitis, esophagitis and hematologic toxicity were 4.4%, 11.2% and 26.4%, respectively.Conclusions CCRT provide stage Ⅲ NSCLC patients favorable outcome with acceptable toxicity.CCRT is standard therapeutic approach for patients with unresectable locally advanced NSCLC.