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目的探讨老年局部晚期非小细胞肺癌(NSCLC)患者同期放化疗和序贯放化疗的临床疗效和不良反应。方法回顾性分析100例局部晚期NSCLC患者资料,采用随机表抽签法分为同期放化疗组和序贯放化疗组,每组50例,比较两组患者的近期疗效、不良反应和生活质量。结果序贯放化疗组患者的总有效率为58.0%,显著低于同期放化疗组(80.0%,P<0.05);同期放化疗组患者的Ⅲ~Ⅳ级血小板减少及急性放射性食管炎发生率分别64.0%和48.0%,明显高于序贯放化疗组(42.0%和26.0%,P<0.05)。治疗前,两组患者躯体功能及总健康状况评分差异无统计学意义(P>0.05);治疗1个月后,同步放化疗组躯体功能及总健康状况评分显著高于序贯放化疗组(P<0.05)。结论相比于序贯放化疗,同期放化疗可提高局部晚期NSCLC的临床疗效及生活质量,不良反应虽比序贯放化疗大,但经积极治疗未出现治疗相关死亡病例,适合在临床上推广。
Objective To investigate the clinical efficacy and side effects of concurrent chemoradiotherapy and sequential chemoradiotherapy in elderly patients with locally advanced non-small cell lung cancer (NSCLC). Methods The data of 100 patients with locally advanced NSCLC were retrospectively analyzed. Randomized culling was divided into concurrent chemoradiotherapy group and sequential chemoradiotherapy group, 50 cases in each group. The curative effect, adverse reaction and quality of life of the two groups were compared. Results The total effective rate was 58.0% in sequential radiochemotherapy group, which was significantly lower than that in concurrent chemoradiotherapy group (80.0%, P <0.05). The incidence of grade Ⅲ ~ Ⅳ thrombocytopenia and acute radiation esophagitis 64.0% and 48.0% respectively, which were significantly higher than those of sequential radiochemotherapy (42.0% and 26.0%, P <0.05). Before treatment, there was no significant difference between the two groups in physical function and total health score (P> 0.05). After 1 month of treatment, the scores of somatic function and total health status in concurrent chemoradiotherapy group were significantly higher than those in sequential radiochemotherapy group P <0.05). Conclusions Compared with sequential chemoradiotherapy, concurrent chemoradiotherapy can improve the clinical efficacy and quality of life of locally advanced NSCLC. Although the adverse reactions are larger than sequential chemoradiotherapy, no treatment-related deaths occur after active treatment, which is suitable for clinical application .