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目的 对比观察非小细胞肺癌单纯放疗和放化综合治疗的疗效。方法 从 1995年 1月到 1997年 12月 ,将符合入组条件的 82例非小细胞肺癌患者随机分为放疗组和化放疗综合治疗组。其中完成治疗计划的有 74例 ,35例属单纯放疗组 ,39例属化放疗综合治疗组。综合治疗组中 2 1例为增敏化疗 (氟脲嘧啶、顺铂 ) ,在放疗的第 1、4周给药 ;18例为联合方案化疗 ,在放疗前、中、后进行 ,最少两周期 ,药物为卡铂、顺铂、足叶乙甙、异环磷酰胺、环磷酰胺等。结果 近期完全缓解率在单放组为 2 3 % (8/35 ) ,放化组为 41% (16 /39)。单放组与综合治疗组的 1、2、3年生存率分别为 48%、2 7%、18%与 6 5 %、39%、19% ,中位生存期分别为 11个月和 18.9个月 ,各组差异均无显著性 (P >0 .0 5 )。单纯组与综合治疗组Ⅲ期病例的 1、2、3年生存率分别为42 %、2 5 %、13 %与 6 7%、38%、2 1% ,各组间比较差异均有显著性 (P <0 .0 5 )。增敏组与联合化疗方案组的 1、2、3年生存率分别为 5 8%、38%、2 6 %和 72 %、36 %、12 % ,各组间比较均无显著性差异 (P >0 .0 5 )。结论 放化综合治疗可以显著提高Ⅲ期非小细胞肺癌的 1、2、3年生存率 ,增敏化疗与联合化疗方案的生存情况有待于大量病例的观察
Objective To compare the efficacy of radiotherapy and radiochemotherapy for non-small cell lung cancer. Methods From January 1995 to December 1997, 82 cases of non-small cell lung cancer patients who met the enrollment criteria were randomly divided into radiotherapy group and combined chemotherapy and radiotherapy group. Among them, 74 cases completed the treatment plan, 35 cases belonged to single radiotherapy group, 39 cases belonged to chemoradiation comprehensive treatment group. Twenty-one patients in the comprehensive treatment group received sensitization chemotherapy (fluorouracil and cisplatin) at the 1st and 4th weeks of radiotherapy; 18 patients received combined regimen chemotherapy before, during, and after radiotherapy, with a minimum of 2 cycles. The drugs are carboplatin, cisplatin, acetochlor, ifosfamide, cyclophosphamide and so on. Results The complete remission rate in the near future was 2 3% (8/35) in the radiotherapy group and 41% (16/39) in the radiochemotherapy group. The 1-, 2-, and 3-year survival rates for the single-release group and comprehensive treatment group were 48%, 27%, 18%, and 65%, 39%, and 19%, respectively, and the median survival time was 11 months and 18.9 respectively. On month, there was no significant difference between groups (P > 0.05). The 1-, 2-, and 3-year survival rates of stage III and stage III patients in the simple group and comprehensive treatment group were 42%, 25%, 13%, and 67%, 38%, and 2%, respectively. There was significant difference between the groups. (P <0. 0 5). The 1-, 2-, and 3-year survival rates of the sensitized group and the combination chemotherapy group were 5 8%, 38%, 2 6%, and 72%, 36%, and 12%, respectively, and there was no significant difference between the groups (P). >0 .0 5 ). Conclusion Radiochemotherapy can significantly improve the 1-, 2-, and 3-year survival rate of stage III non-small cell lung cancer. The survival of sensitized chemotherapy and combined chemotherapy regimens needs to be observed in a large number of cases.