李臻　吴圣豪　池琼

[摘要] 目的 探讨吉西他滨序贯化放疗在非小细胞肺癌中的疗效及不良反应。 方法 对2016年3月～2017年3月来我院就诊的非小细胞肺癌患者资料进行回顾性分析。所有患者共62例，均为病理和临床活检被确诊为非小细胞肺癌患者，给予所有患者吉西他滨序贯化疗方案进行治疗，并按照世界卫生组织的标准评价患者的临床疗效以及不良反应对患者进行随访，观察患者的生存周期。 结果 本次研究共62例患者，62例可评价临床疗效，其中42例（67.7%）病情得到缓解，19例（30.6%）病情基本稳定，1例（1.7%）病情无改善，持续发展。生存期为4.8～26.5个月，平均（14.3±5.9）个月。不良反应发生率为64.5%，主要包括21例血液毒性现象，19例消化道症状。 结论 吉西他滨序贯化放疗对非小细胞肺癌患者有一定的临床应用价值，可以延长患者生存周期，但存在一定的不良反应，因此，临床上使用需要考虑患者耐受问题。

[关键词] 吉西他滨；非小细胞肺癌；放疗；化疗

[中图分类号] R734.2 [文献标识码] B [文章编号] 1673-9701（2018）23-0057-04

Effectiveness and adverse reaction of gemcitabine sequential chemotherapy followed by radiotherapy in patients with non-small-cell lung cancer

LI Zhen WU Shenghao CHI Qiong

Wenzhou Central Hospital in Zhejiang Province， Wenzhou 325000， China

[Abstract] Objective To investigate the effectiveness and adverse reaction of gemcitabine sequential chemotherapy followed by radiotherapy in patients with non-small-cell lung cancer （NSCLC）. Methods Records of patients with NSCLC in our hospital from March 2016 to March 2017 were analyzed retrospectively. There were 62 patients diagnosed as NSCLC by pathological examination and clinical biopsy. All the patients were treated with gemcitabine sequential chemotherapy. The clinical effectiveness and adverse reaction in patients were assessed according to WHO guideline. Follow-up visit was paid to observe patients' survival. Results 62 patients were involved and the clinical effectiveness could be assessed in all of them. Out of them， 42 patients（67.7%） got remission， 19 patients （30.6%） were with comparatively stable disease and 1 patient（1.7%） did not get improved and with progressive disease. Survival ranged from 4.8 to 26.5 months， averaged（14.3±5.9） months. The incidence of adverse reaction was 64.5%， mainly including 21 cases with hematological toxicity and 19 cases with alimentary symptoms. Conclusion Gemcitabine sequential chemotherapy followed by radiotherapy was clinical valuable in patients with NSCLC and could extend the survival of patients. The tolerance of patients should be considered when applied in clinic since there would be some adverse reaction.

[Key words] Gemcitabine； Non-small-cell lung cancer； Radiotherapy； Chemotherapy

肺癌是世界上死亡因素前三位的疾病之一，是最常見的恶性肿瘤。而非小细胞肺癌作为肺癌的一种，占肺癌总人数的80%，因此在临床受到广泛的关注[1-4]。非小细胞型肺癌包括鳞状细胞癌（鳞癌）、腺癌、大细胞癌，与小细胞癌相比其癌细胞生长分裂较慢，扩散转移相对较晚，因此，患者发现时大多处于中期或者晚期，影响了患者的治愈情况和生存率。非小细胞癌症患者早期大多表现为胸部胀痛、咳嗽发热等症状，发展到中后期会出现疲乏、体重减轻、食欲下降，甚至还会出现呼吸困难、咳嗽、咯血等局部症状，严重影响到患者的生存质量，因此，针对非小细胞肺癌的治疗需要引起广大医学工作者的重点关注[5-8]。……