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目的研究三维适形放疗联合化疗同步治疗局限期小细胞肺癌的生存疗效、耐受性、不良反应。方法放疗方案为每次照射1.8Gy,每周5次DT61.2Gy/34次。化疗方案为EP方案(DDP25～30mg/m2d1-3+vp16100mgd1-5)每3周重复1次,从第1周期始即同步放、化疗,放疗完成后继续3疗程EP方案化疗,每3周重复1次,若CR后可行全脑预防性照射。结果中位生存时间25个月,局部复发率29%,完全缓解率(CR)71%(15/21),部分缓解PR率20%(4/21),无变化和进展(NR+PD)率9%(2/21),放射性食管炎38%(8/21),2例发生Ⅰ～Ⅱ级放射性肺炎,18例白细胞下降,但经G-CSF治疗后恢复正常,后期并发症2例出现I级肺纤维化。结论三维适形放疗联合化疗同步治疗局限期小细胞肺癌,提高了局控率和生存率,耐受性好,达CR的患者建议行PCI。
Objective To study the efficacy, tolerability and adverse effects of three-dimensional conformal radiotherapy combined with chemotherapy in the treatment of small cell lung cancer (NSCLC). Methods Radiation program for each irradiation 1.8Gy, 5 times a week DT61.2Gy / 34 times. The chemotherapy regimen is EP regimen (DDP25-30mg / m2d1-3 + vp16100mgd1-5) repeated once every three weeks, from the beginning of the first cycle of simultaneous radiotherapy and chemotherapy, radiotherapy continue after 3 cycles of EP regimen chemotherapy, repeated every 3 weeks 1 times, if CR after feasible whole brain preventive irradiation. Results The median survival time was 25 months, the local recurrence rate was 29%, the complete response rate (CR) 71% (15/21), partial response PR rate 20% (4/21), no change and progression (NR + PD) (2/21), radioactive esophagitis 38% (8/21), 2 cases of grade Ⅰ ~ Ⅱ radiation pneumonitis, 18 cases of leukopenia, but returned to normal after treatment with G-CSF and 2 cases of late complications Class I pulmonary fibrosis appears. Conclusion Three-dimensional conformal radiotherapy combined with chemotherapy for the treatment of locally advanced small cell lung cancer (SLCC) improves the control rate and survival rate. It is well tolerated and recommended for patients with CR.