Dai Youyi, Jiang Wuzhong, Yuan Jun, Wei Rui
Department of Oncology, Xiangya Hospital, Central South University, Changsha 410008, China.
Zhongguo Fei Ai Za Zhi. 2011 Feb;14(2):137-40. doi: 10.3779/j.issn.1009-3419.2011.02.06.
Sequential and concurrent chemoradiotherapy were widely studied in locally advanced non-small cell lung cancer (NSCLC), but the reports of induction chemotherapy followed concurrent chemoradiotherapy are rare so far. The little side effects of paclitaxel liposme may be convenient to carry out induction chemotherapy followed concurrent chemoradiotherapy. The aim of this study is to compare the effects and side effects of TP regimen (Paclitaxel liposme and cisplatin) induction chemotherapy followed concurrent chemoradiotherapy with sequential radiotherapy on locally advanced NSCLC.
Sixty locally advanced NSCLC patients were randomly divided into group A, induction chemotherapy followed concurrent chemoradiotherapy and group B, sequential radiotherapy group. The patients in group A received 2-3 cycles of induced chemotherapy included of Paclitaxel liposme 135 mg/m²-175 mg/m², d1 and cisplatin 70 mg/m²-80 mg/m², d2, 3 weeks repeat and after 2-3 cycles followed by concurrent chemoradiotherapy. The patients in group B received chemotherapy, (as described above in group A) 4-6 cycles of chemotherapy followed one cycle of radiotherapy. The three-dimensional conformal radiotherapy at the total dose of 56 Gy-70 Gy was applied in all patients.
The response rate in group A and group B were 80.3% and 60%, respectively (P=0.042). 1-year survival rates were 71.4% and 53.2%, respectively (P=0.18). And there were no significant difference of myelosuppression, radiation esophagitis and pulmonary fibrosis between the two groups (P=0.09, P=0.147, P=0.276, respectively).
The recent effects of induction chemotherapy followed by concurrent chemoradiotherapy group were better than sequential radiotherapy group on locally advanced NSCLC and there was no significant difference in side effects between the two groups.
序贯和同步放化疗在局部晚期非小细胞肺癌（NSCLC）中得到广泛研究，但诱导化疗后序贯同步放化疗的报道迄今较少。紫杉醇脂质体副作用小，可能便于实施诱导化疗后序贯同步放化疗。本研究旨在比较TP方案（紫杉醇脂质体和顺铂）诱导化疗后序贯同步放化疗与序贯放疗对局部晚期NSCLC的疗效和副作用。
60例局部晚期NSCLC患者随机分为A组（诱导化疗后序贯同步放化疗）和B组（序贯放疗组）。A组患者接受2 - 3周期诱导化疗，包括紫杉醇脂质体135mg/m² - 175mg/m²，第1天；顺铂70mg/m² - 80mg/m²，第2、3天，3周重复，2 - 3周期后序贯同步放化疗。B组患者接受化疗（同A组）4 - 6周期化疗后序贯1周期放疗。所有患者均采用三维适形放疗，总剂量56Gy - 70Gy。
A组和B组的有效率分别为80.3%和60%（P = 0.042）。1年生存率分别为71.4%和53.2%（P = 0.18）。两组间骨髓抑制、放射性食管炎和肺纤维化无显著差异（分别为P = 0.09，P = 0.147，P = 0.276）。
诱导化疗后序贯同步放化疗组对局部晚期NSCLC的近期疗效优于序贯放疗组，两组间副作用无显著差异。
