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伽玛刀联合培美曲塞/卡铂同步治疗局部晚期非小细胞肺癌的临床观察

Clinical Effects of Whole Body Gamma Knife Combined with Pemetrexed Plus Carboplatin on Concurrent Chemoradiotherapy for Locally Advanced Non-small Cell Lung Cancer

  • 摘要: 目的 观察体部伽玛刀联合培美曲塞/卡铂同步治疗局部晚期非小细胞肺癌的临床疗效及不良反应。方法42例局部晚期非小细胞肺癌患者,其中ⅢA期18例,ⅢB期24例;腺癌26例,鳞癌16例,给予体部伽玛刀放疗同步联合培美曲塞/卡铂方案化疗(培美曲塞500 mg/m2+卡铂AUC=5,第一天,3周重复,共4周期)。评价临床疗效和不良反应。结果近期有效率(CR+PR)为85.7%;1、2年生存率及中位生存期分别为76.2%、45.2%和18.6月;所有不良反应均为Ⅰ~Ⅲ级,未出现Ⅳ级,并以骨髓抑制、胃肠道反应及放射性食管炎为主要表现。其中发生Ⅲ级白细胞下降5例(11.9%)。结论 体部伽玛刀联合培美曲塞/卡铂方案同步治疗局部晚期非小细胞肺癌有满意的近期及远期疗效,并具有良好的安全性和可耐受性。

     

    Abstract: Objective To evaluate the clinical effects and adverse reactions of whole body gamma knife combined with pemetrexed plus carboplatin on concurrent chemoradiotherapy for locally advanced non-small cell lung cancer(LANSCLC). Methods Total 42 cases of LANSCLC patient were selected.They included ⅢA stage NSCLC(18 cases) and ⅢB stage NSCLC(24 cases);adenocarcinoma (26 cases) and squamous carcinoma (16 cases).All of the patients underwent whole body gamma knife combined with pemetrexed plus carboplatin in concurrent chemoradiotherapy (pemetrexed 500 mg/m2 and carboplatin AUC=5 were administrated to the patients on the first day of every three-weeks for four cycles.) Clinical efforts and adverse reactions were evaluated. Results The response rate (CR+PR) was 85.7%,The 1-,2-year survival rates and the median survival periods were 76.2%,45.2%,18.6 months,respectively;All the adverse reactions were between gradeⅠ~Ⅲ,which were mainly bone marrow suppression,gastrointestinal reactions and radiation esophagitis.No grade Ⅳ adverse reaction had been occurred.Leukopenia was occurred in 5 cases (11.9%) of grade Ⅲ. Conclusion Whole body gamma knife combined with pemetrexed plus carboplatin in concurrent chemoradiotherapy has a relatively good short and remote effectiveness,with good safety and tolerability.

     

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