文档介绍：概况40%的病人就诊时已属晚期大部分难以完全手术切除单纯放射治疗的中位生存期9-10月,5年生存率5%>60Gy,胸内控制率为50%(20年前的资料)纤支镜检查结果:局控率低,剂量>60Gy,<20%?联用放射增敏药物(包括化疗药物)+放疗同步(低剂量,常规剂量)同步放化疗+巩固化疗诱导化疗+,%VariablesRadiotherapyRadiotherapyandWeeklyCisplatinRadiotherapyandDailyCisplatinDuration1-Yr4654442-Yr1326193-..诱导化疗+放疗(III期临床试验) KPS>=70,weightloss<5%theCancerandLeukemiaGroupB(CALGB)8433trial[DillmanRO,JNatlCancerInst1996;88:1210-1215]随机分组:诱导组(chemoradiation)vinblastine5mg/m2weekly×5wkcisplatin100mg/m2wk1and5RT60Gy/6w对照组(radiationalone):RT60Gy/6w结果:mediansurvival:CR:;RT::CR:19%;RT:7%..RTOG88-08trialThemediansurvival:-yrsurvivalrates:8%and5%.结论诱导化疗+放疗是无法手术的stageIIINSCLC的标准方案80%患者局控失败远处转移率在联合组显著低于单照组,+同步放化疗FrenchCEBItrial[LeChevalierT,JNatlCancerInst1991;83:417-423]ResectableNSCLC.