放热化综合治疗非小细胞肺癌的远期疗效
Radio-thermo-chemotherapy for lung cancer
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摘要: 目的: 探讨放热化综合治疗非小细胞肺癌(NSCLC)的最佳组合、临床方法及远期疗效。方法: 非小细胞肺癌(NSCLC)88例,其中放热化和单放组各30例、放热组28例;鳞癌73例、腺癌14例、类癌1例。采用常规放射治疗方法,每次照射1.8~2Gy,每周5次,肿瘤照射剂量50~70Gy;使用8MHz射频热疗机,放疗后30~60min内热疗,持续60min,肿瘤温度41~43℃,每周2次,8~12次为一疗程;化疗在放疗后、热疗前或热疗中进行,每周一次。结果: 总有效率和1年、3年、5年生存率分别为: 放热化组70%、76.7%、43.3%和23.3%;放热组67.9%、75%、32.1%和14.3%;单放组53.3%、63.3%、20%和6.7%;3和5年生存率: 放热化组与单放组差异显著(P<0.05)。死亡67例、8例失访;死亡原因为远地转移33例;局部复发26例;非癌性死亡8例。结论: 放热化综合治疗对降低NSCLC远地转移和肿瘤局部复发具有一定临床价值,是一条能提高远期生存率的有效治疗方法。Abstract: Objective: To explore the effect of this combination treatment on lung cancer and their different optimal matched method Methods: 88 lung cancer patients(squamous carcinoma 73,adenocarcinoma 14,carcinoid 1) were randomly divided into three groups: radio thermo chemotherapy group for 30.cases,radio thermotherapy group 28 cases and radiotherapy alone group 30.cases The radiation dose was 60.70Gy in radiotherapy group and 50.60Gy in the other two groups The thermotherapy was performed 30.60min after radiotherapy treatment for 60.min twice a week,for 8 12 times The tumor temperature reached 41℃ 43℃ Chemotherapy composed of DDP,VCR,CTX and ADM was performed between the radiation and thermotherapy or after thermotherapy once a week The chest CT was measured and compared before and after the treatment Results: The effective rate and 1,3,5 year survival were 70%,76 7%,43 3% and 23 3% in radio thermo chemotherapy group;67 9%,75%,32 1% and 14 3% in radio thermotherapy group;53 3%,63 3%,20% and 6 7% in radiation group Survival in radio thermo chemotherapy group was higher than radiation alone group at 3,5 years (P<0.005,using χ 2 test) Conclusion: The effect of radio thermo chemotherapy is superior to that of radiotherapy alone for lung cancer and is a good treatment method to improve the survival
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