同步放化疗治疗老年局部晚期非小细胞肺癌的临床研究

目的：探讨长春瑞滨、吉西他滨分别联合三维适形放疗治疗老年局部晚期非小细胞肺癌（ＮＳＣＬＣ）的疗效和毒性反应。方法：８１例患者分为两组，长春瑞滨组：三维适形放疗同步化疗，长春瑞滨２５ｍｇ／ｍ^２，静滴，第１、８天。吉西他滨组：三维适形放疗同步化疗，吉西他滨１０００ｍｇ／ｍ^２，静滴第１、８天。均２１天为１周期。两组均治疗２～４周期。结果：长春瑞滨组ＣＲ率１７.５％，ＰＲ率５０.０％，总有效率（ＣＲ＋ＰＲ）为６７.５％；吉西他滨组ＣＲ率１９.５％，ＰＲ率４６.３％，总有效率（ＣＲ＋ＰＲ）为６５.８％，两组差异无显著性（Ｐ＞０.０５）。长春瑞滨组和吉西他滨组的１、２年生存率分别为６９３％、３６.４％和６８.７％和１８.６％，中位生存时间分别为１７个月和１６.２个月，差异无显著性（Ｐ＞０.０５）。长春瑞滨３～４级血液毒性高于吉西他滨组（Ｐ＜０.０５）。结论：长春瑞滨或吉西他滨联合三维适形放疗同步治疗老年局部晚期ＮＳＣＬＣ安全、有效。

Analysis of effect of concurrent chemoradiotherapy on elderly patients with locally advanced non small cell lung cancer

Objective：To evaluate the efficacy and toxicity of vinorelbine,gemcitabine and concurrent 3-dimensional conformal radiotherapy on elderly patients with locally advanced non-small cell lung cancer.Methods：Eighty-one patients were divided into the following groups：group A was given to 3-dimensional conformal radiotherapy and concurrent chemotherapy（vinorelbine 25mg/m^2 on day 1,8 of 21-day cycle,each patient should complete at least 2 cycles）,group B was given to 3-dimensional conformal radiotherapy and concurrent chemotherapy（gemcitabine 1 000mg/m^2 on day 1,8 of 21-day cycle,each patient should complete at least 2 cycles）.Results：The overall response rate was 67.5% in group A and was 65.8% in group B,respectively（P〉0.05）.The survival rate was 69.3% at 1 year,36.4% at 2 year,the medion survival was 17 months for group A and compared with 68.7%,18.6%,16.2 months for group B,respectively（P〉0.05）.The rate grade 3-4 myelsuppression in group A was higher than in group B（P=0.002）.Conclusion：Vinorelbine,gemcitabine and concurrent 3-dimensional conformal radiotherapy on elderly patients with locally advanced non-small cell lung cancer is a well-tolerated regimen in acceptable toxicity and will be an optimal therapy more effective treatment.Schems are reqired to improve disease control and overall survival.