欢迎访问《现代生物医学进展》编辑部！

目的：观察氟西汀联合同步放化疗治疗局部晚期非小细胞肺癌（none small cells lung carcinoma，NSCLC）的临床疗效及其安全性。方法：选择2010 年10 月～2011 年4 月我院收治的Ⅲ期不能手术的NSCLC 患者47 例，根据患者的入院顺序，随机分为两组，同步放化疗组（对照组）22 例，接受三维适形或调强放疗：肿瘤处方剂量60～66 Gy，常规分割：1.8～2.0 Gy/ 次；放疗期间同步两周期“紫杉醇＋顺铂”方案化疗，放疗后再原方案巩固化疗2～3 个周期；氟西汀联合治疗组（实验组）25 例，从同步放化疗开始起同时服用氟西汀（20～40 mg/day），持续服药半年。随访至1 年，观察和评价两组的疗效以及不良反应的发生情况。结果：对照组与实验组的客观有效率分别为77.3 %（17/22）和80%（20/25）（P>0.05）；1 年生存率分别为68.2%（15/22）和80 %（20/25）（P>0.05）；1 年局控率分别为45.5 %（10/22）和76 %(19/25)，差异有统计学意义（P<0.05）。治疗后，实验组患者CD+/CD8+比率由1.34± 0.23 升至1.58± 0.22（P<0.05），而汉密尔顿抑郁量表（HAMD）总分由13.4± 4.8 降至9.6± 3（P<0.05）；全组患者主要不良反应为骨髓抑制、消化道反应、放射性食管炎和放射性肺炎，未发生4 级不良反应，两组3 级不良反应发生率无明显差异（P>0.05）。结论：对于不能手术的局部晚期NSCLC 患者，在同步放化疗的基础上联合氟西汀治疗可以提高肿瘤的1 年局控率，促进抗肿瘤免疫，并缓解患者的抑郁情绪，且不加重不良反应。

英文摘要:

Objective:To evaluate the efficacy and safety of continuous Fluoxetine administration combined with concurrent chemoradiotherapy (C-CRT) for local advanced non-small cell lung cancer.Methods:From October 2010 to April 2011, 47 patients with unresectable stage Ⅲ NSCLC were randomly assigned to one of the two treatment arms: C-CRT group were treated with three dimensional conformal radiation therapy (3D-CRT) or intensity modulated radiation therapy (IMRT) to a total dose of 60-66 Gy at 1.8-2.0 Gy per fraction, 2 cycles of TP chemotherapy was carried concurrent with radiotherapy and followed by 2-3 cycles of TP chemotherapy thereafter. Fluoxetine group were additionally administered with 20-40 mg Fluoxetine daily for 6 months besides chemoradiotherapy.Results:The response rates and 1 year overall survival rate were 77.3% (17/22), 68.2% (15/22) and 80%(20/25), 80% (20/25) in C-CRT group and Fluoxetine group, respectively (P>0.05). 1 year local control rate were 45.5% (10/22) and 76 % (19/25) in C-CRT group and Fluoxetine group, respectively (P<0.05). CD4+/CD8+ ratio raised from 1.34± 0.23 to1.58± 0.22 (P<0.05), HAMD score decreased from13.4± 4.8 to 9.6± 3 (P<0.05) in Fluoxetine group, meanwhile no changes were observed in C-CRT group. The main side effects included anemia/leucopenia /thrombocytopenia, nausea/vomiting, radiation esophagitis and radiation pneumonitis. No differences in grade 3 side-effect was observed between these two groups. Conclusion:Compared with C-CRT alone, additional Fluoxetine administration provided higher 1 year local control rate for local advanced NSCLC patients. Fluoxetine administration helped to regain immune balance and alleviate depression without additional side effect.

查看全文查看/发表评论下载PDF阅读器

关闭