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目的评价NP方案即长春瑞滨(NVB)联合顺铂(DDP)放化同步治疗局部晚期非小细胞肺癌(NSCLC)的临床近期疗效及毒副反应。方法 30例晚期NSCLC患者同时接受NP方案化疗及肺内原发灶和区域淋巴结X线放疗,每次放疗剂量为2.0 GY,每周5次,总剂量60 GY。放疗与化疗同一天开始,NVB(盖诺)25 mg/m2,DDP 30 mg/m2,第1天,第8天,第29天,第36天给药,放疗结束3周后,常规给予NP方案全身化疗2个周期。NVB25～30 mg/m2,第1天,第8天,DDP 75 mg/m2,分3 d给药,21～28 d为1个周期。结果同步放化疗联合全身化疗的有效率为76.7%(23/30),其中完全缓解(CR)5例(16.7%),部分缓解(PR)18例(60.0%)。毒副反应以可逆性骨髓抑制、消化道反应、放射性食管炎为主。其中白细胞减少发生率为90.0%(27/30),Ⅲ～Ⅳ度骨髓抑制发生率33.3%(10/30),消化道反应、放射性食道炎症状轻微,给予预防和对症治疗可缓解。结论 NP方案放化同步治疗是综合治疗局部晚期NSCLC的安全有效的手段。
Objective To evaluate the clinical short-term efficacy and toxicity of NP regimen, vinorelbine (NVB) combined with cisplatin (DDP) radiochemotherapy in the treatment of locally advanced non-small cell lung cancer (NSCLC). Methods Thirty patients with advanced NSCLC were treated with NP regimen and primary lung tumor and regional lymph node X-rays at the same time. Each radiation dose was 2.0 GY, 5 times per week, and the total dose was 60 GY. On the same day of radiotherapy and chemotherapy, NVB (25 mg/m2) and DDP (30 mg/m2) were given on the 1st, 8th, 29th, and 36th day. Three weeks after the end of radiotherapy, NP was routinely administered. The regimen consists of 2 cycles of systemic chemotherapy. NVB 25-30 mg/m2, on the 1st and 8th day, DDP 75 mg/m2, administered 3 days, 21-28 days was 1 cycle. Results The effective rate of simultaneous radiotherapy and chemotherapy combined with systemic chemotherapy was 76.7% (23/30), including complete remission (CR) in 5 patients (16.7%) and partial remission (PR) in 18 patients (60.0%). The toxic side effects were mainly reversible myelosuppression, digestive tract reaction, and esophagitis. The incidence of leukopenia was 90.0% (27/30). The incidence of myelosuppression in grades III to IV was 33.3% (10/30). The severity of gastrointestinal reactions and esophageal inflammatory symptoms was mild and could be alleviated by prevention and symptomatic treatment. Conclusion NP regimen radiochemotherapy is a safe and effective method for comprehensive treatment of locally advanced NSCLC.