【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（Plt;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 (Plt;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.
目的 观察消化道肿瘤患者服用甲羟孕酮（medroxyprogesterone acetate, MPA）对化疗后骨髓抑制的影响。 方法 2008年11月-2009年8月，将接受化疗的消化道肿瘤患者共100例随机分为治疗组(MPA加化疗组，54例)及对照组(单纯化疗组，46例)，2周期化疗后评价骨髓抑制状况和生活质量变化。 结果 治疗组和对照组化疗后白细胞、血红蛋白和血小板Ⅰ~Ⅱ度骨髓抑制发生率没有差异（Pgt;0.05），但治疗组Ⅲ~Ⅳ度骨髓抑制发生率低于对照组，KPS评分改善率高于对照组（Plt;0.05）。未见明显不良反应。 结论 MPA可有效减轻化疗后骨髓抑制。