作者对31例局部进展期非小细胞肺癌加速超分割放疗同时每日卡铂化疗的可靠性和有效性进行了评估。受试对象为局部进展期不能手术切除而又无远处转移或恶性胸水的病人,中位年龄73岁,主要为临床Ⅲ_A(32％)或Ⅲ_B(48％)。整个治疗连续进行:每日早晨放疗前15分钟给予卡铂(25mg/m~2)+盐水100ml静注,4周总剂量500mg/m~2,每日胸部放疗2次(每次1.5Gy),前后野对照,包括肿瘤边缘外1.5cm,放射至45Gy,缩野放射,总剂量60Gy,5次/周,4周完成。脊髓剂量限制在45Gy以内。第一天查血液游离铂药代动力学。以WHO毒性标准评价急性和晚期毒性反应。肿瘤反应在治疗结束后以放疗模式和放化疗综合模式评价。药代动力学分析结果以血液中每毫升铂质量表示。 31例病人全部如期完成治疗。主要的急性毒性反应(三级以上)有白细胞减少症(55％),血栓性血细胞减少症(16％),食管炎(23％)。放射野内肿瘤反应率为84％,其中3例完全反应,23例部分反应。复发类型主要是局部区域内复发,中位生存时间9.8个 The authors evaluated the reliability and efficacy of daily accelerated carboplatin chemotherapy in 31 patients with locally advanced NSCLC. Subjects were patients who could not be surgically resected and had no distant metastasis or malignant pleural effusion at a locally advanced stage. The median age was 73 years and was mainly clinical III_A (32%) or III_B (48%). The entire treatment was performed continuously: 15 minutes before morning radiotherapy, carboplatin (25mg/m~2) + saline 100ml intravenously, 4 weeks total dose 500mg/m~2, daily chest radiotherapy 2 times (1.5Gy each time) Before and after the wild control, including the edge of the tumor 1.5cm, radiation to 45Gy, shrink field radiation, the total dose of 60Gy, 5 times / week, 4 weeks to complete. The spinal dose is limited to 45 Gy. The blood pharmacokinetics of free platinum was checked on the first day. Acute and late toxicity reactions were evaluated using the WHO toxicity criteria. Tumor response was evaluated after radiotherapy with a combination of radiotherapy and radiotherapy and chemotherapy. The results of the pharmacokinetic analysis are expressed as the mass of platinum per milliliter in the blood. All 31 patients completed treatment on schedule. The main acute toxicity (grade 3 or higher) was leukopenia (55%), thrombotic cytopenia (16%), and esophagitis (23%). The tumor response rate in the radiation field was 84%, of which 3 were completely reactive and 23 were partially responsive. The recurrence type is mainly local recurrence with a median survival time of 9.8