1.Clinical effects of gamma knife combined with pemetrexed plus carboplatin in concurrent or sequential chemoradiotherapy of locally advanced non-small cell lung cancer
Heng XU ; Wanning TONG ; Anshan ZHUO ; Yushu CAO ; XuShilin
Journal of Navy Medicine 2016;37(4):302-305,309
Objective To observe the clinical effects and adverse reactions of gamma knife combined with pemetrexed plus carboplatin in concurrent or sequential chemoradiotherapy of locally advanced non-small cell lung cancer( LANSCLC) .Methods A to-tal of 125 cases of LANSCLC were randomly divided into 3 groups, in accordance with different therapeutic methods.The concurrent group ( or group A, 30 cases) received body gamma knife combined with pemetrexed plus carboplatin.The sequential group ( or group B, 31 cases) was given 2 weeks of chemotherapy with pemetrexed and carboplatin, then sequential body gamma knife radiotherapy and finally underwent two cycles of chemotherapy with the same regimen.The radiotherapy group ( or group C, 64 cases) was given just body gamma knife radiotherapy.Clinical therapeutic effects and adverse reactions were evaluated.Results The short-term effects for group A, group B and group C were respectively 83.33%, 77.42%and 73.44%, and no statistical significance could be seen when comparisons were made between them(P<0.05).The 1-2-year survival rate and the median survival time for group A were respectively 73.33%, 43.33%and 17.5 months, those for group B were respectively 64.52%, 35.48%and 15.4 months, and those for group C were respectively 46.88%, 23.44%and 10.6 months.Analyses indicated that group A was superior to group B, and group B was su-perior to group C, with the former having a better survival rate, and no statistical significance could be noticed when comparisons were made between them(P>0.05).However, there was statistical significance when comparisons were made between group A and group C (P<0.05).With regard to toxic reactions, all the adverse reactions were from gradeⅠ-Ⅲ, with bone marrow suppression and gastro-intestinal reactions as the main manifestations.GradeⅣadverse reaction never occurred.There was no statistical significance in the in-cidence rates of radiation-induced esophagiti and pneumonitis, when comparisons were made between the 3 groups(P>0.05).With re-gard to the incidence rates of bone marrow suppression and adverse reactions of the digest system, there was no statistical significance, when comparisons were made between group A and group B(P>0.05).However, statistical significance could be noted, when compari-sons were made between group A/B and group C(P>0.05).Conclusion Body gamma knife combined with pemetrexed and carboplatin in concurrent chemoradiotherapy was more superior to body gamma knife alone, furthermore it displayed better safety and higher tolerance.

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