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目的观察放疗联合化疗治疗局限期小细胞肺癌(LD-SCLC)的临床疗效,并比较不同干预方式的临床效果。方法经病理组织学证实的49例LD-SCLC,分组进行放疗联合化疗,其中EP同步组25例,顺铂40mg/m2、第1~3天,足叶乙苷100mg/d、第1~4天,化疗前2个周期同步进行放疗,同步治疗结束后继续单独进行4个周期化疗;EP序贯组24例,顺铂40mg/m2、第1~3天,足叶乙苷100mg/d、第1~4天,在4个周期化疗后开始放疗,放疗结束后继进行2个周期化疗。放疗采用调强放射治疗,剂量56~60Gy分28~30次,放疗范围为原发病灶、肺动脉、肺静脉、支气管及淋巴组织及同侧纵隔。结果 EP同步组和EP序贯组的完全缓解率分别为80.0%和58.3%,1、2、3年局部控制率分别为92.0%、80.0%、48.0%和79.2%、54.2%、29.2%,3年生存率分别为32.0%和20.8%,远处转移率分别为60.0%和70.8%,组间差异均有统计学意义(P<0.05)。两组患者近期不良反应差异无统计学意义。结论 EP同步治疗LD-SCLC取得较好的临床疗效优于EP序贯治疗。
Objective To observe the clinical efficacy of radiotherapy combined with chemotherapy in the treatment of small cell lung cancer (LD-SCLC) and to compare the clinical effects of different interventions. METHODS: Forty-nine patients with LD-SCLC confirmed by histopathology were divided into radiotherapy and chemotherapy group, including 25 patients in EP group, 40 mg / m2 cisplatin, 100 mg / day etoposide 100 mg / Day, two cycles before chemotherapy, radiotherapy simultaneously, after the end of concurrent treatment continue to be a separate cycle of four cycles of chemotherapy; EP sequential group of 24 patients, cisplatin 40mg / m2, 1 to 3 days, etoposide 100mg / d, On day 1 to day 4, radiotherapy was started after 4 cycles of chemotherapy, followed by 2 cycles of chemotherapy. Radiotherapy using intensity-modulated radiation therapy, dose 56 ~ 60Gy 28 to 30 times, the scope of the primary radiotherapy radiotherapy, pulmonary artery, pulmonary veins, bronchial and lymphatic tissues and ipsilateral mediastinum. Results The complete remission rate was 80.0% and 58.3% in EP group and EP group respectively. The local control rates at 1, 2 and 3 years were 92.0%, 80.0%, 48.0% and 79.2%, 54.2% and 29.2% respectively. The 3-year survival rates were 32.0% and 20.8%, respectively. The distant metastasis rates were 60.0% and 70.8% respectively. There was significant difference between the two groups (P <0.05). The two groups of patients with no significant difference in recent adverse reactions. Conclusion EP synchronous treatment of LD-SCLC achieved better clinical efficacy than EP sequential treatment.