化療方案對(duì)局部晚期非小細(xì)胞肺癌同步放化療的影響分析
發(fā)布日期：2007-09-20 16:30 文章來(lái)源：<a href="http://www.dxy.cn">丁香園</a>
關(guān)鍵詞： 肺癌
化療
CSCO
腫瘤學(xué)大會(huì)
點(diǎn)擊次數(shù)：
中國(guó)醫(yī)學(xué)科學(xué)院腫瘤醫(yī)院 任 華 王綠化 王小震 呂紀(jì)馬 周宗玫 歐廣飛 殷蔚伯
??? Abstract Objective: To retrospectively analyze the effects of different concurrent chemotherapyregimens on locally advanced non–small-cell lung carcinoma (NSCLC).Methods and Materials: Datawere analyzed from 106 patients pathologically diagnosed as NSCLC (Ⅲa:29,Ⅲb:77) and receivedconcurrent external beam radiotherapy with various chemotherapy regimens. Analysis was performedfor overall survival, progression-free survival, and toxicity (grade≥2). Results: Paclitaxel basedchemotherapy regimen was delivered in 55 patients (51.9%), whereas 21 patients(19.8%) withtopotecan regimen and 26 patients (24.5%)with PE (cisplatin and etopside) regimen, 4 patients hadother chemotherapy regimens . The median follow-up time for surviving patients was 14.4 months, themedian survival time was 18.6 months, the overall 1-，2- and 3-year survival rate were 72.2%, 41.1%and 27.5%, respectively. Survival and toxicity analysis were performed in 102 patients which includedpaclitaxel , topotecan and PE groups , the median survival time was 16.3 months, 27.3 months and 29.1months, respectively. The overall survivals of topotecan and PE groups were superior to paclitaxelbased group, but not signifcant (P=0.32). Howerevr, when topotecan and PE group were combined (47patients) and compared to paclitaxel based regimen group, the median survival was poorer in patientswith paclitaxel based regimen (16.3 months vs 27.3 months), and both in univariate and multivariateanalysis paclitaxel based chemotherapy regimen was significantly associated with poorer survival (P<0.05). N stage was significant in the Cox multivariate regression model. Paclitaxel based regimen wasassociated with more acute radiation pneumonitis, 27.3% versus 10.6%, (P=0.03), less blood toxicity(16.4% vs 29.8%) (P=0.108) and almost same esophagitis(29.1% vs 34.0%). Conclusions: Thisretrospective analysis showed a correlation between concurrent chemotherapy regimens with survivaland toxicity in patients with locally advanced NSCLC. Further study for chemotherapy regimens inconcurrent chemoradiation is needed.
??? Key Words Non–small-cell lung carcinoma；Radiotherapy；Chemotherapy；Regimen；Treatment
??? 局部晚期非小細(xì)胞肺癌占非小細(xì)胞肺癌的30%～40%，單純放療5年生存率只有5%～10%，序貫化放療與其相比可以提高5年生存率8%～17%，患者預(yù)后仍然不佳。二十世紀(jì)后期開(kāi)始，國(guó)外多個(gè)Ⅰ-Ⅱ期臨床試驗(yàn)顯示同步放化療可取得較為理想的療效，多個(gè)研究中心的Ⅲ期臨床研究證實(shí)以同步放化療為主的治療模式可提高局部晚期非小細(xì)胞肺癌的生存率，同步放化療已成為局部晚期非小細(xì)胞肺癌的標(biāo)準(zhǔn)治療。目前不同研究中心開(kāi)展同步治療研究選用的化療方案不一，尚未見(jiàn)到針對(duì)同步治療的化療方案的臨床研究意見(jiàn)。我院自1999年以來(lái)開(kāi)展了的多種化療方案的同步放化療治療局部晚期非小細(xì)胞肺癌的臨床實(shí)踐，本文采用隊(duì)列研究的方法比較我院1999年4月～2005年10月采用不同化療方案的同步放化療治療局部晚期非小細(xì)胞肺癌的療效及毒性反應(yīng)。
編輯: blue 作者:丁香園通訊員