放疗联合易瑞沙治疗不能手术且不能行同步放化疗的局部晚期非小细胞肺癌的Ⅱ期临床研究的初步结果

发布时间：2018-06-27 01:50

  本文选题：非小细胞肺癌 + 放射治疗　； 参考：《北京协和医学院》2017年硕士论文

【摘要】：目的:观察放疗联合易瑞沙治疗不能手术且不能行同步放化疗的局部晚期非小细胞肺癌患者的近期疗效、生存和安全性。材料与方法:选取不能手术且不能行同步放化疗的局部晚期非小细胞肺癌患者,在中国医学科学院肿瘤医院放疗科接受胸部调强放疗,同期接受易瑞沙250mg每日一次的治疗。结果:从2014年7月至2017年3月,入组30例,可分析29例。放疗结束后1月部分缓解(PR)、稳定(SD)和进展(PD)分别有21(72.4%)、6(20.7%)和2(6.9%)例,治疗反应率(CR+PR+SD)为93.1%,客观有效率(CR+PR)为72.4%。放疗结束后3月PR、SD和PD分别有15(53.6%)、6(21.4%)和7(25%)例,治疗反应率为75%,客观有效率为53.6%(因1例患者治疗结束未达3个月,共28例参与放疗结束后3月疗效评价)。随访截止日期2017年5月15日,中位随访18个月,死亡8例(27.6%),存活21例(72.4%);20例(68.9%)患者出现疾病进展,其中局部进展16例(55.2%),远处转移8例(27.6%)。全组的MST未达到,中位PFS 11个月,1年OS和PFS分别为83.9%和44.5%,2年OS和PFS分别为66.7%和21.4%。单因素分析显示分期、原发灶直径和PTV的体积对PFS有意义(p0.001,95%CI:3.12-57.17;p=0.025,95%CI:9.70-12.38;p =0.036,95%CI:9.70-12.38),多因素分析显示分期和PTV体积为PFS的独立预后因素(p=0.001,95%CI:-13.63--1.78;p=0.001,95%CI:1.16-12.61)。ⅢB 期 OS 和 PFS 均优于ⅢA 期。全组未观察到4级急性不良反应,3级急性不良反应共2例(6.9%),2级急性放射性肺炎7例(24.1%),未观察到3级急性放射性肺炎。结论:对于不能手术且不能行同步放化疗的局部晚期非小细胞肺癌,放疗联合易瑞沙的治疗,近期疗效尚可,患者耐受良好,远期疗效有待进一步观察。
[Abstract]:Objective: to observe the short-term efficacy, survival and safety of radiotherapy combined with Irelisha in the treatment of locally advanced non-small cell lung cancer (NSCLC). Materials and methods: patients with locally advanced non-small cell lung cancer (NSCLC) who could not be operated on and who could not be treated with concurrent radiotherapy were treated with intensity-modulated chest radiotherapy (IMRT) in the department of radiotherapy of Cancer Hospital of the Chinese Academy of Medical Sciences (CAS). The patients were treated with 250mg once a day at the same time. Results: from July 2014 to March 2017, there were 30 cases in the group and 29 cases were analyzed. There were 21 (72.4%) cases of partial remission (PR), 6 (20.7%) of stable (SD) and 2 (6.9%) of progression (PD) at one month after radiotherapy. The therapeutic response rate (CR PR SD) was 93.1%, and the objective effective rate (CR PR) was 72.4%. There were 15 (53.6%) cases of PRSD and 7 (25%) cases of PD at 3 months after radiotherapy. The response rate was 75 and the objective effective rate was 53.6%. The median follow-up date was May 15, 2017. The median follow-up period was 18 months, 8 patients died (27.6%), 21 patients survived (72.4%), 20 patients (68.9%) had disease progression, 16 patients had local progression (55.2%), 8 patients had distant metastasis (27.6%). The MST of the whole group was not reached, the median PFS was 83.9% and 44.5% in 11 months, OS and PFS in 1 year, and 66.7% and 21.4% in 2 years, respectively. Univariate analysis showed that staging, diameter of primary focus and volume of PTV were significant to PFS (p0.00195 CI: 3.12-57.17). Stage 鈪，

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