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目的：回顾性分析同期放化疗与序贯放化治疗Ш 期不能手术非小细胞肺癌的近期疗效、生存期及毒性反应，以指导临床治疗。方法：对生存资料完整的86 例经组织学或细胞学证实的非小细胞肺癌病例进行回顾性分析，序贯放化组42 例，同期化放组 44 例。同期放化疗组：治疗方式为放疗期间周期性化疗，三维适形调强放疗。治疗后不常规进行巩固化疗，随访如血液肿瘤标志物 CEA 数值动态观察增高，则进行全身化疗1～2 周期。序贯化放疗组先化疗3～7 周期后放疗，放疗方法与同期放化疗组相同。结果：同期化放组肿瘤完全缓解率显著高于序贯化放疗组的(P＜0.05)；中位生存期分别为24 与18 个月，1、2 年生存率分别为 88%、49%和84%、35%（P＜0.05）；急性期毒副反应经对症后均恢复而未影响治疗，两组病例中的毒副反应相似，差别无统计学意义。结论：同步放化疗较序贯放化疗治疗Ш 期非小细胞肺癌能提高完全缓解率、中位生存时间、1、2 年生存率，且未增加患者的毒性反应，为Ш 期非小细胞肺癌提供一种安全有效的治疗方法。

英文摘要:

Objective: To guide the clinic treatment by retrospectively analysising the response, survival, progression time and toxicity of concurrent or sequential Chemoradiotherapy for stage Ш non-smal-cell lung cancer (NSCLC). Methods: Eighty-six patients with stage Ш NSCLC treated with new concurrent radiochemotherapy (cRT group 44cases) or sequential chemotherapy(sRT group 42 cases) were entered into the database for analysis. All patients used the conventional fractionated radiotherapy and three dimension comfort radiotherapy. In sRT group, patiets received three to seven cycles chemotherapy firstly, then to irradiate, the method was indentical with anterior two parts in cRT. Results: Comparison of complete respose rate, median survival time (month) 1-,2-year survival rates in cRT and sRT groups showed 70.5%(31/44) and 47.6%(20/42/24 and 18.88%, 49%and84%, 35%（x2=4.217，P=0.04）.The progression (ralaps or metastas) rate was 45.5%、73.8% respectively in cRT and sRT groups.The midian free progression time was 14 and 10 month. The toxicity rate was samiliar in cRT and sRT groups. All above figures had statistical meanings. Conclusion: Concurrent chemoradiotherapy seems to be better than the sequential counter-partfor NSCLC in complete respose rate, madian survival time (month), 1-,2-year survival rates, without increasing the toxicity in cRT group.

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