目的 评价多西他赛联合顺铂同步放疗治疗不能手术切除的局部晚期非小细胞肺癌(non-small-cell lung cancer, NSCLC)的近期疗效和急性不良反应。方法 120例患者随机分为两组, 其中同步放化疗组60例, 采用多西他赛联合顺铂同步放疗。放疗采用6/15 MV X线, 每周照射5次, 每次200 cGy, 共治疗4周；有锁骨上淋巴结转移者, 给予X线和电子线混合照射至DT 60～66 Gy。在放疗开始后的1、8、15 d, 于放疗前4 h给予多西他赛20～25 mg/m², 顺铂 40 mg/m²化疗。单纯放疗组60例, 治疗方法与同步放化疗组的放疗方法相同。结果 同步放化疗组与单纯放疗组有效率分别为90.0％和70.0％(P<0.05)；两组不良反应主要为骨髓抑制、胃肠道反应、放射性食管炎、放射性肺炎和肝功能受损等, 经处理后均可耐受, 差异无统计学意义。结论 多西他赛联合顺铂有放疗增敏作用, 较单纯放疗能够提高NSCLC近期疗效, 急性不良反应增加不明显。

Objective To evaluate the feasiblity and safety of combined docetaxel and cisplatin chemotherapy with a sensitizer and concurrent radio-chemotherapy in stage Ⅲ NSCLC．Methods Sixty patients with inoperable stage Ⅲ NSCLC were treated with docetaxel, cisplatin and radiotherapy．Chemotherapy consisted of intravenously docetaxel 20-25 mg/m² on days 1, 8, 15, cisplatin 40 mg/m² on days 1, 8, 15. Radiotherapy was delivered up to a total dose of 66-70 Gy with a 2.0 Gy dose fraction per day, 5 days per week．Sixty patients underwent radiotherapy．Results The overall response rates of primary tumors and mediastinum metastatic nodes were 90.0％ and 70.0％, respectively (P<0.05). The acute side effects in patients were mostly myelosuppression, nausea, vomiting, radiation induced esophagitis and pneumonitis, and liver toxicity．However, all of them were tolerant．Conclusions Combined chemo-radiotherapy has good response and survival as compared with conventional radiotherapy in the treatment of locally advanced non-small-cell lung cancer without aggravating the side effects．Docetaxel and cisplatin should be used as a radiosensitizer.