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目的探讨三维适形放射治疗联合长春瑞滨或吉西他滨治疗晚期非小细胞肺癌的近期疗效及不良反应。方法 164例Ⅲ～Ⅳ期不能手术切除的非小细胞肺癌(NSCLC)患者随机分为两组,先行诱导化疗后以三维适形放射治疗与化疗同步治疗,其中A组83例患者以长春瑞滨+顺铂为化疗方案,B组81例患者以吉西他滨+顺铂为化疗方案;分别统计两组患者完全缓解(CR)、部分缓解(PR)、稳定(SD)和进展(PD)例数及不良反应发生情况。结果 A组患者总有效率(CR+PR)为47.0%,疾病控制率(CR+PR+SD)为74.1%,1年生存率为54.2%,疾病进展时间为4.8个月,Ⅲ～Ⅳ度不良反应发生率为30.1%。B组患者总有效率为38.3%,疾病控制率为67.7%,1年生存率为40.4%,疾病进展时间为5个月,Ⅲ～Ⅳ度不良反应发生率为29.6%。两组比较,A组总有效率、疾病控制率和1年生存率均高于B组(均P<0.05);疾病进展时间和重度不良反应发生率两组间差异无统计学意义(P>0.05)。结论三维适形放射治疗联合长春瑞滨治疗晚期非小细胞肺癌近期疗效较好,不良反应均能耐受。
Objective To investigate the short-term curative effect and side effects of three-dimensional conformal radiotherapy combined with vinorelbine or gemcitabine in the treatment of advanced non-small cell lung cancer. Methods One hundred and sixty-four patients with unresectable non-small cell lung cancer (NSCLC) from stage Ⅲ to Ⅳ were randomly divided into two groups. The patients were treated with three-dimensional conformal radiation therapy and chemotherapy simultaneously. Among them, 83 patients in group A received vinorelbine + Cisplatin for chemotherapy, 81 patients in group B received gemcitabine plus cisplatin as chemotherapy regimen. The numbers of complete remission (CR), partial remission (PR), stable (SD) and progress (PD) Adverse reactions occurred. Results The total effective rate (CR + PR) in group A was 47.0%, the disease control rate (CR + PR + SD) was 74.1%, the 1-year survival rate was 54.2%, the disease progression time was 4.8 months, The incidence of adverse reactions was 30.1%. The total effective rate in group B was 38.3%, the disease control rate was 67.7%, the one-year survival rate was 40.4%, the disease progression time was 5 months, and the incidence of grade Ⅲ-Ⅳ adverse reactions was 29.6%. The total effective rate, disease control rate and 1-year survival rate in group A were higher than those in group B (all P <0.05). There was no significant difference between the two groups in disease progression time and incidence of serious adverse reactions (P> 0.05). Conclusion Three-dimensional conformal radiotherapy combined with vinorelbine in the treatment of advanced non-small cell lung cancer has good curative effect in the near future and the adverse reactions can be tolerated.