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顺铂和长春瑞滨用于非小细胞肺癌术后局部区域复发的挽救性放化疗。

Salvage chemoradiotherapy with cisplatin and vinorelbine for postoperative locoregional recurrence of non-small cell lung cancer.

作者信息

Hisakane Kakeru, Yoh Kiyotaka, Nakamura Naoki, Udagawa Hibiki, Kirita Keisuke, Umemura Shigeki, Matsumoto Shingo, Niho Seiji, Akimoto Tetsuo, Tsuboi Masahiro, Goto Koichi

机构信息

Department of Thoracic Oncology Department of Radiation Oncology Department of Thoracic Surgery, National Cancer Center, Kashiwa, Japan.

出版信息

Medicine (Baltimore). 2017 Nov;96(47):e8635. doi: 10.1097/MD.0000000000008635.

Abstract

Although a few investigators have demonstrated the effect of concurrent chemoradiotherapy (CRT) for postoperative recurrent non-small cell lung cancer (NSCLC), the outcome of this treatment remains unclear. The aim of this study was to elucidate the efficacy and tolerability of concurrent CRT with cisplatin (CDDP) and vinorelbine (VNR) in patients with postoperative locoregional recurrent NSCLC. A total of 40 patients who had received concurrent CRT with CDDP and VNR between January 1999 and December 2014 were retrospectively analyzed. Patients were treated with CDDP (80 mg/m on day 1) and VNR (20 mg/m on days 1 and 8) every 4 weeks. Radiotherapy was administered concurrently during cycle 1. The delivered x-ray radiation dose was 60 Gy in all 37 patients who received x-ray radiotherapy; 3 patients received proton beam radiation (66 Gy [RBE] in 1 patient and 60 Gy [RBE] in 2 patients). The objective response rate was 85% (95% confidence interval [CI], 70.9%-92.9%). The median progression-free survival was 20.3 months (95% CI, 12.9 months-not reached). The 2-year survival rate was 78.9% (95% CI, 63.0%-89.1%). The most common grade ≥3 toxicity was neutropenia (18%). No grade ≥3 radiation pneumonitis and no treatment-related deaths were observed.Our study revealed that concurrent CRT with CDDP and VNR was active and safe for patients with postoperative locoregional recurrent NSCLC. Salvage CRT for postoperative locoregional recurrent NSCLC might be a promising treatment for selected patients.

摘要

尽管有少数研究者证实了同步放化疗(CRT)对术后复发性非小细胞肺癌(NSCLC)的疗效,但这种治疗的结果仍不明确。本研究的目的是阐明顺铂(CDDP)和长春瑞滨(VNR)同步CRT治疗术后局部区域复发性NSCLC患者的疗效和耐受性。回顾性分析了1999年1月至2014年12月期间接受CDDP和VNR同步CRT的40例患者。患者每4周接受一次CDDP(第1天80mg/m²)和VNR(第1天和第8天20mg/m²)治疗。在第1周期同时进行放疗。在接受X线放疗的所有37例患者中,X线辐射剂量为60Gy;3例患者接受质子束放疗(1例患者为66Gy[相对生物效应],2例患者为60Gy[相对生物效应])。客观缓解率为85%(95%置信区间[CI],70.9%-92.9%)。中位无进展生存期为20.3个月(95%CI,12.9个月-未达到)。2年生存率为78.9%(95%CI,63.0%-89.1%)。最常见的≥3级毒性是中性粒细胞减少(18%)。未观察到≥3级放射性肺炎,也未观察到与治疗相关的死亡。我们的研究表明,CDDP和VNR同步CRT对术后局部区域复发性NSCLC患者有效且安全。术后局部区域复发性NSCLC的挽救性CRT可能是部分患者的一种有前景的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6c5/5708934/208ebf32c5ca/medi-96-e8635-g001.jpg

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