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目的探讨伊立替康/顺铂联合影像引导放疗对非小细胞肺癌(non-small cell lung cancer,NSCLC)的疗效和可行性。方法晚期NSCLC患者,行为状态评分为0~1,化疗方案为顺铂75 mg/m2(分3次于第1~3天给药),伊立替康设3个剂量组(50、60、70 mg/m2),分别于第1、8、15天给药,28 d重复,共给予2~3个周期,同期采用kV-CBCT引导3D适形胸部放疗[2.0 Gy/(次.d),总剂量66 Gy]。结果伊立替康最大耐受剂量为60 mg/m2,剂量限制毒性为中性白细胞减少和食管炎。肿瘤缓解率75%,中位生存期11.5个月,随访未观察到症状性肺炎或食管炎发生。结论Ⅲ期NSCLC患者采用胸腔图像引导3D适形放疗66 Gy联合同步伊立替康加顺铂化疗(伊立替康60 mg/m2,顺铂75 mg/m2),能为患者耐受。
Objective To investigate the efficacy and feasibility of irinotecan / cisplatin combined with guided radiotherapy for non-small cell lung cancer (NSCLC). Methods Patients with advanced NSCLC had a behavioral status score of 0-1. The chemotherapy regimen consisted of cisplatin 75 mg / m2 (administered 3 times on days 1 to 3) and irinotecan (3 doses 60, 50, 70, mg / m2) were administered on days 1, 8 and 15, respectively, for 28 days. A total of 2 to 3 cycles were given. Over the same period, kV-CBCT was used to guide 3D conformal chest radiotherapy [2.0 Gy / Total dose of 66 Gy]. Results The maximum tolerated dose of irinotecan was 60 mg / m2 and the dose limiting toxicity was neutropenia and esophagitis. The tumor remission rate was 75%, and the median survival time was 11.5 months. No symptomatic pneumonia or esophagitis was observed during follow-up. Conclusions Patients with stage Ⅲ NSCLC can be tolerated by chest radiography with 66 Gy of 3D conformal radiotherapy and irinotecan plus cisplatin chemotherapy (irinotecan 60 mg / m2, cisplatin 75 mg / m2).