一项针对 III 期非小细胞肺癌（NSCLC）患者，在诱导化疗使用顺铂（CDDP）和长春瑞滨（VNR）后进行超分割加速放疗（HART）的 II 期研究。

A phase II study of hyperfractionated accelerated radiotherapy (HART) after induction cisplatin (CDDP) and vinorelbine (VNR) for stage III non-small-cell lung cancer (NSCLC).

作者信息

Ishikura Satoshi, Ohe Yuichiro, Nihei Keiji, Kubota Kaoru, Kakinuma Ryutaro, Ohmatsu Hironobu, Goto Koichi, Niho Seiji, Nishiwaki Yutaka, Ogino Takashi

机构信息

Division of Radiation Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwa-noha, Kashiwa 277-8577, Japan.

出版信息

Int J Radiat Oncol Biol Phys. 2005 Mar 15;61(4):1117-22. doi: 10.1016/j.ijrobp.2004.07.692.

DOI:10.1016/j.ijrobp.2004.07.692

PMID:15752891

Abstract

PURPOSE

The purpose was to assess the feasibility and efficacy of hyperfractionated accelerated radiotherapy (HART) after induction chemotherapy for Stage III non-small-cell lung cancer.

METHODS AND MATERIALS

Treatment consisted of 2 cycles of cisplatin 80 mg/m(2) on Day 1 and vinorelbine 25 mg/m(2) on Days 1 and 8 every 3 weeks followed by HART, 3 times a day (1.5, 1.8, 1.5 Gy, 4-h interval) for a total dose of 57.6 Gy.

RESULTS

Thirty patients were eligible. Their median age was 64 years (range, 46-73 years), 24 were male, 6 were female, 8 had performance status (PS) 0, 22 had PS 1, 9 had Stage IIIA, and 21 had Stage IIIB. All but 1 patient completed the treatment. Common grade > or =3 toxicities during the treatment included neutropenia, 25; infection, 5; esophagitis, 5; and radiation pneumonitis, 3. The overall response rate was 83%. The median survival was 24 months (95% confidence interval [CI], 13-34 months), and the 2-year overall survival was 50% (95% CI, 32-68%). The median progression-free survival was 10 months (95% CI, 8-20 months).

CONCLUSION

Hyperfractionated accelerated radiotherapy after induction of cisplatin and vinorelbine was feasible and promising. Future investigation employing dose-intensified radiotherapy in combination with chemotherapy is needed.

摘要

目的

评估诱导化疗后超分割加速放疗（HART）用于Ⅲ期非小细胞肺癌的可行性和疗效。

方法和材料

治疗包括每3周进行2个周期的顺铂80mg/m²（第1天）和长春瑞滨25mg/m²（第1天和第8天），随后进行HART，每天3次（1.5、1.8、1.5Gy，间隔4小时），总剂量为57.6Gy。

结果

30例患者符合条件。他们的中位年龄为64岁（范围46 - 73岁），24例为男性，6例为女性，8例体能状态（PS）为0，22例PS为1，9例为ⅢA期，21例为ⅢB期。除1例患者外，所有患者均完成治疗。治疗期间常见的≥3级毒性包括中性粒细胞减少25例；感染5例；食管炎5例；放射性肺炎3例。总缓解率为83%。中位生存期为24个月（95%置信区间[CI]，13 - 34个月），2年总生存率为50%（95%CI，32 - 68%）。中位无进展生存期为10个月（95%CI，8 - 20个月）。