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目的探讨老年晚期非小细胞肺癌(NSCLC)的有效综合治疗方案。方法将163例≥70岁Ⅲ期NSCLC患者随机分为3组。放疗组54例,常规分割前后野照射40 Gy后缩野照射至60 Gy,有淋巴结转移者加照60 Gy;化疗组54例,采用紫杉醇联合卡铂低剂量持续给药治疗6周期,4W为一周期;同步组55例,化疗开始第9天开始放疗,方法同上两组,直至疗程结束。结果同步组、放疗组、化疗组有效率分别为65.5%、57.4%、46.3%,同步组疗效明显优于化疗组(χ2≈4.0581,P<0.05);与放疗组接近(χ2≈0.7450,P>0.05),其1、2、3年生存率分别为65.5%、38.2%、18.2%,45.5%、20.3%、7.4%,51.9%、24.1%、11.1%,中位生存期分别为15、10、12个月,同步组与另两组比较差异有统计学意义(P<0.05)。同步组不良反应较多且重,但能耐受,均未影响治疗计划。结论紫杉醇联合卡铂低剂量6周期化疗同步放疗治疗老年晚期NSCLC能明显提高有效率和生存率,不良反应加重但能耐受,是治疗老年晚期NSCLC安全有效的综合治疗方案。
Objective To investigate the effective treatment of advanced non-small cell lung cancer (NSCLC). Methods 163 patients with stage Ⅲ NSCLC ≥70 years were randomly divided into three groups. Radiotherapy group of 54 cases, 40 Gy before and after routine segmentation of field irradiation to 60 Gy, with lymph node metastasis plus 60 Gy; chemotherapy group of 54 patients treated with low-dose paclitaxel plus carboplatin for 6 cycles One cycle; synchronous group of 55 patients, chemotherapy began on the 9th day of radiotherapy, the same way as the two groups until the end of treatment. Results The effective rates of the synchronous group, the radiotherapy group and the chemotherapy group were 65.5%, 57.4% and 46.3% respectively. The curative effect of the synchronous group was better than that of the chemotherapy group (χ2≈4.0581, P <0.05) 0.05). The 1, 2, 3 year survival rates were 65.5%, 38.2%, 18.2%, 45.5%, 20.3%, 7.4%, 51.9%, 24.1% and 11.1% respectively. The median survival time was 15, At 10 and 12 months, there was significant difference between the synchronous group and the other two groups (P <0.05). Synchronization group more adverse reactions and heavy, but can tolerate, did not affect the treatment plan. Conclusions Combination of paclitaxel and carboplatin in low-dose 6-cycle chemotherapy with concurrent radiotherapy for senile advanced NSCLC can significantly improve the efficiency and survival rate, with increased adverse reactions but can tolerate. It is a safe and effective comprehensive treatment for elderly patients with advanced stage NSCLC.