Recent Therapeutic Effect of Late Course 3 Dimensional Conformal Therapy Concomitant with Chemotherapy on Stage Ⅲ Non-small-cell Lung Cancer_West China Medical Journal

Authors：

ZHAO Caixia ¹ , REN Yongjun ² ,  WEN Shimin ¹ , LI Guangming ¹ , PAN Rongqiang ¹

1. Department of Tumor, Nanchong Central Hospital, Nanchong,Sichuan 637000, P. R. China; 2. Department of Intervention, North Sichuan Medical College, Nanchong,Sichuan 637000, P. R. China;

Corresponding author：

WEN Shimin, Email: chinaxcdb@yahoo.com.cn

Keywords：

非小细胞肺癌; 适形; 放射疗治; 化学疗法

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【摘要】　目的　探讨后程适形放射治疗（3 dimensional comformal radiation therapy，3D-CRT）同步化学疗法治疗Ⅲ期非小细胞肺癌（non-small-cell lung cancer，NSCLC）的近期疗效。　方法　搜集2005年1月-2008年6月NSCLC患者共115例，其中53例行单纯后程3D-CRT（单放组），62例行后程3D-CRT联合同步化学疗法（联合组），所有患者均经病理证实为Ⅲ期NSCLC。两组放射治疗方案均采用常规分割治疗加后程3D-CRT，DT 62～72 Gy。联合组化学疗法采用TP（紫杉醇 + 顺铂）方案。　结果　单放组和联合组近期疗效（完全缓解+部分缓解）分别为75.47%、91.94%，差异有统计学意义（P lt;0.05）。单放组和联合组的治疗不良反应主要有白细胞、血小板减少，放射性食管炎，放射性气管炎，恶心、呕吐等胃肠道反应。骨髓抑制和消化道反应，联合组稍高于单放组。经对症治疗后，所有患者均可耐受。　结论　后程3D-CRT联合TP方案化学疗法较单纯后程适形放射治疗明显提高Ⅲ期NSCLC近期疗效。患者耐受性尚可。
【Abstract】　Objective　 To observe the recent therapeutic effect of late course 3 dimensional conformal therapy concomitant with chemotherapy on locally advanced stage Ⅲ non-small-cell lung cancer (NSCLC).　Methods　 From January 2005 to June 2008, 115 patients with stage Ⅲ NSCLC were confirmed by pathology, in whom 53 only underwent late course conformal therapy (radiotherapy group), and another 62 underwent late course conformal therapy concomitant with chemotherapy (combined group). The radiotherapy schema of the two groups was routine division plus late course conformal therapy (with DT 62-72 Gy). The chemotherapy schema in the combined group was performed with TP (paclitaxel and DDP).　Results　 The recent curative effect (complete remission plus partial remission) in radiotherapy group and combined group was 75.47% and 91.94%, respectively (P lt;0.05). The frequent adverse reactions in the two groups included leucocytopenia, thrombocytopenia, radioactive esophagitis, radioactive tracheitis, nauseated, and emesia. The rate of bone marrow depression and alimentary canal reaction in combined group was higher than that in the radiotherapy group. In the two groups, all patients could tolerance the treatments.　Conclusion　 Late course 3 dimensional conformal therapy concomitant with TP schema chemotherapy for NSCLC could raise the recent curative effect. The patients could tolerance the treatments.

Citation： ZHAO Caixia,REN Yongjun,WEN Shimin,LI Guangming,PAN Rongqiang. Recent Therapeutic Effect of Late Course 3 Dimensional Conformal Therapy Concomitant with Chemotherapy on Stage Ⅲ Non-small-cell Lung Cancer. West China Medical Journal, 2011, 26(2): 216-218. doi: Copy

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11.	Schwachöfer JH, Crooijmans RP, Hoogenhout J, et al. Effectiveness in inhibition of recovery of cell survival by cisplatin and carboplatin: influence of treatment sequence[J]. Int J Radiat Oncol Biol Phys, 1991, 20(6): 1235-1241.
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1. 　殷蔚伯, 余子豪, 徐国镇, 等. 肿瘤放射治疗学[M]. 北京: 中国协和医科大学出版社, 2008: 578.
2. 　Newlin HE, Iyengar M, Morris CG, et al. Unresectable squamous cell carcinoma of the lung: an outcomes study[J]. Int J Radiat Oncol Biol Phys, 2009, 74(2): 370-376.
3. 　El Sharouni SY, Aerts JG, Senan S, et al. Treatment of patients with stage Ⅲ non-small cell lung cancer: concurrent high-dose chemotherapy and radiotherapy[J]. Ned Tijdschr Geneeskd, 2008, 152(50): 2714-2717.
4. 　林贵山, 程惠华, 傅志超, 等. 晚期非小细胞肺癌同步放化疗的疗效分析[J]. 中华放射肿瘤学杂志, 2006, 15(6): 462-466.
5. 　Socinski MA, Morris DE, Halle JS, et al. Induction and concurrent chemotherapy with high-dose thoracic conformal radiation therapy in unresectable stage IIIA and IIIB non-small-cell lung cancer: a dose-escalation phase I trial[J]. J Clin Oncol, 2004, 22(21): 4341-4350.
6. 　Bradley JD, Bae K, Graham MV, et al. Primary analysis of the phase Ⅱ component of a phase Ⅰ/Ⅱ dose intensification study using three-dimensional conformal radiation therapy and concurrent chemotherapy for patients with inoperable non-small-cell lung cancer: RTOG 0117[J]. J Clin Oncol, 2010, 28(14): 2475-2480.
7. 　李慧, 杜小波, 廖东彪, 等. 三维适形放疗与NP方案同步治疗Ⅲ期非小细胞肺癌的近期疗效观察[J]. 华西医学, 2007, 22(2): 264-265.
8. 　Liang SX, Zhu XD, Xu ZY, et al. Radiation-induced liver disease in three-dimensional conformal radiation therapy for primary liver carcinoma: the risk factors and hepatic radiation tolerance[J]. Int J Radiat Oncol Biol Phys, 2006, 65(2): 426-434.
9. 　Rosenman JG, Halle JS, Socinski MA, et al. High-dose conformal radiotherapy for treatment of stage ⅢA/ⅢB non-small-cell lung cancer: technical issues and results of a phase Ⅰ/Ⅱ trial[J]. Int J Radiat Oncol Biol Phys, 2002, 54(2): 348-356.
10. 　朱礼, 吴荣. Ⅲ期非小细胞肺癌同期放化疗与序贯放化疗的对照研究[J]. 中华肿瘤防治杂志, 2009, 16(14): 1105-1107.
11. 　Schwachöfer JH, Crooijmans RP, Hoogenhout J, et al. Effectiveness in inhibition of recovery of cell survival by cisplatin and carboplatin: influence of treatment sequence[J]. Int J Radiat Oncol Biol Phys, 1991, 20(6): 1235-1241.
12. 　Fietkan R. Concomitant radiochemotherapy of advanced non-small-cell lung cancer[J]. Lung Cancer, 2001, 33(Suppl 1): 65-76.

West China Medical Journal

Recent Therapeutic Effect of Late Course 3 Dimensional Conformal Therapy Concomitant with Chemotherapy on Stage Ⅲ Non-small-cell Lung Cancer

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