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目的观察分析三维适形放疗同步化疗与序贯化疗治疗局部晚期非小细胞肺癌的疗效及不良反应。方法将53例局部晚期非小细胞肺癌患者随机分为两组:同步组(27例)和序贯组(26例)。同步组采用三维适形放疗(3DCRT)联合吉西他滨和顺铂同步化疗,放疗后再予以吉西他滨及顺铂化疗2个周期;序贯组采用3DCRT结束后,予以吉西他滨和顺铂化疗4个周期。结果同步和序贯两组有效率(PR+CR)分别为70.4%和53.8%,两组比较差异无统计学意义(P>0.05);1年生存率分别为81.5%和61.5%,2年生存率分别为37.0%和26.9%,两组比较差异无统计学意义(P>0.05);中位生存期为17.0个月和13.0个月,两组比较差异有统计学意义(P<0.05)。不良反应以骨髓抑制、放射性食管炎为主,差异无统计学意义(P>0.05)。结论 3DCRT联合吉西他滨同步化疗在近期疗效上优于序贯化疗,在不良反应上无差别。
Objective To observe the curative effect and adverse reactions of three-dimensional conformal radiotherapy and sequential chemotherapy in the treatment of locally advanced non-small cell lung cancer. Methods 53 patients with locally advanced non-small cell lung cancer were randomly divided into two groups: synchronous group (27 cases) and sequential group (26 cases). Synchronous group was treated with 3DCRT combined with gemcitabine and cisplatin simultaneously, followed by gemcitabine and cisplatin chemotherapy for 2 cycles after radiotherapy. Gemcitabine and cisplatin were given to the sequential group after 4 cycles of 3DCRT. Results The effective rates (PR + CR) of the two groups were 70.4% and 53.8%, respectively. There was no significant difference between the two groups (P> 0.05). The 1-year survival rates were 81.5% and 61.5% The survival rates were 37.0% and 26.9% respectively. There was no significant difference between the two groups (P> 0.05). The median survival time was 17.0 months and 13.0 months. There was significant difference between the two groups (P <0.05) . Adverse reactions to bone marrow suppression, radiation esophagitis, the difference was not statistically significant (P> 0.05). Conclusions 3DCRT combined with gemcitabine is superior to sequential chemotherapy in the short term efficacy, with no difference in adverse reactions.