紫杉醇脂质体联合顺铂同步放疗治疗局部晚期非小细胞肺癌的临床观察.doc

精品论文 参考文献 紫杉醇脂质体联合顺铂同步放疗治疗局部晚期非小细胞肺癌的临床观察 王继营 李峻 田丹 罗洋 (云南省第二人民医院肿瘤科 云南昆明 650021) 【摘要】目的 探讨紫杉醇脂质体联合顺铂同步放疗治疗局部晚期非小细胞肺癌（NSCLC）的疗效和毒副反应。方法　36例患者行常规分割放疗40 Gy，针对局部病灶行三维适形放疗（3DCRT）加量至中位总剂量达68Gy/34次（66-70 Gy/33-35次）。化疗方案为紫杉醇脂质体135mg/m2静脉滴注第1天，顺铂（诺欣）20mg/(m2静脉滴注，第1—4天。结果　全组36例均可评价疗效，总有效率(CR+PR)为69.4%。中位缓解期为9.2个月,中位生存期为14.8个月，1年、2年的生存率分别为66.7%和44.4%。主要毒性反应为白细胞减少Ⅲ度17例(47.2%)，Ⅳ度3例(8.3%)。急性放射性肺炎1-2级14例（38.9%）；急性放射性食管炎1-2级17例（47.2%），3级2例（5.6%）。结论　紫杉醇脂质体加顺铂同步放化疗治疗局部晚期NSCLC局控率较高，骨髓毒副反应较明显，急性放射性损伤大多数患者尚可耐受。 【关键词】非小细胞肺癌/放、化疗法 化学疗法 放射疗法 常规/三维适形 【中图分类号】R730.5 【文献标识码】A 【文章编号】2095-1752（2013）25-0117-02 Paclitaxel liposome plus cisplatin combined with concurrent chemo-radiotherapy for locally advanced non small cell cancer Wang JI-ying, Li Jun, Tian Dan. et, al.The Second Hospital of Yunnan province ,kunming 650021 【Abstract】 Objective: To evaluate the acute side effects and clinical efficacy of paclitaxel liposome plus cisplatin(DDP) combined with concurrent chemo-radiotherapy for locally advanced non small cell cancer. Methods: The first conventional fractionation radiotherapy 36 patiets were treated to the total dose of 40Gy.The second 3DCRT the primary tumor bed were treated to the total dose of 28～36Gy.paclitaxel liposome135mg/ m2 by intravenous infusion on day1, and DDP 20mg/ m2 by intravenous infusion on day 1-4. Results: The response rate(RR) was 69.4%.Median TTP was 9.2 months,median overall survival time was 14.8 months,and the 1-year,2-year overall survival time was 66.7% and 44.4%.16 patients had radiation pneumonitis Ⅰ-Ⅱ degree. 17 patients had radiation esophagitis,3 patients had Ⅲ degree.Conclusion: Paclitaxel liposome plus cisplatin(DDP) combined with concurrent chemo-radiotherapy for locally advanc locally advance NSCLC with good immediate tumor response and acceptable normal tissue complication. 【Key Words】 Carcinoma,non-small cell lung cancer Chemotherapy Radiotherapy conventional fractionation/thre