CAJ | 학술논문

目的比较三维适形放疗(3DCRT)同期DF方案(顺铂加氟尿嘧啶)化疗治疗新疆哈萨克族和汉族中晚期食管癌的近远期疗效及不良反应差异.方法 112例中晚期食管癌患者中汉族68例,哈萨克族44例.化疗方案为氟尿嘧啶1000 mg/m2连续24 h静脉滴注加顺铂20 mg/m.第1～4天静脉滴注,21 d为1个周期,共4～6个周期.3DCRT从化疗第1天开始,常规分割,DT60～66 Gy分30～33次6～7周完成.结果随访率为100%,哈萨克族和汉族随访满2年者分别为23、27例.哈萨克族和汉族的有效率分别为77%和85%(X2=4.89,P=0.180),1、2年生存率分别为75%和59%、52%和40%(X2=1.71,P=0.191).哈萨克族和汉族3～4级急性放射性食管炎发生率分别为5%和7%(X2=1.66,P=0.435),3～4级急性放射性肺炎发生率分别为2%和1%(X2=0.99,P=0.608),3～4级血液学反应发生率分别为9%和29%(X2=6.57,P=0.037).结论 3DCRT同期DF方案化疗治疗新疆哈萨克族和汉族中晚期食管癌患者的近远期疗效相似,血液学不良反应不同,哈萨克族患者耐受性较好.
목적 비교삼유괄형방료(3DCRT)동기DF방안(순박가불뇨밀정)화료치료신강합살극족화한족중만기식관암적근원기료효급불량반응차이.방법 112례중만기식관암환자중한족68례,합살극족44례.화료방안위불뇨밀정1000 mg/m2련속24 h정맥적주가순박20 mg/m.제1～4천정맥적주,21 d위1개주기,공4～6개주기.3DCRT종화료제1천개시,상규분할,DT60～66 Gy분30～33차6～7주완성.결과 수방솔위100%,합살극족화한족수방만2년자분별위23、27례.합살극족화한족적유효솔분별위77%화85%(X2=4.89,P=0.180),1、2년생존솔분별위75%화59%、52%화40%(X2=1.71,P=0.191).합살극족화한족3～4급급성방사성식관염발생솔분별위5%화7%(X2=1.66,P=0.435),3～4급급성방사성폐염발생솔분별위2%화1%(X2=0.99,P=0.608),3～4급혈액학반응발생솔분별위9%화29%(X2=6.57,P=0.037).결론 3DCRT동기DF방안화료치료신강합살극족화한족중만기식관암환자적근원기료효상사,혈액학불량반응불동,합살극족환자내수성교호.
Objective To study the short-term curative effects and side effects of the three-dimensional conformal radiotherapy combined with chemotherapy in advanced esophageal cancer in Xinjiang provenience.Methods One hundred and twelve cases were divided into Kazak and Han nationality group according to the different nations.Chemotherapy was DF regime:5-Fu 1000 ms/m2+DDP 20 mg/m2,d1-4,21 days as a cycle,total 4-6 cycles.For both groups,3DCRT was carried out by conventional fractionation with total dose of 60-66 Gy/30-33frin 6-7w.Results The following-up rate was 100%.The number of pailents followed up at two years wero 23 and 27 in Kazak and Han nationality group,respectively.The immediate effective rates(CR(complete remission)+PR(partial remission))were 77%(34/44)and 85%(58/68)in ban and kazak group,respectively(X2=4.89,P=0.180).The 1-and 2-year survival rate were 75%,59%and 52%,40%(X2=1.71,P=0.191)in Kazak and Han group,respectively.The 3-4grade radioesophagitis were 5%(2/44)and 7%(5/68)in kazak group and han group,respectively(X2=1.66,P=0.435).The 3-4 grade radiopneumonia were 2%(1/44)and 1%(1/68)in kazak group and ban group,respectively(X2=0.99,P=0.608).The 3-4 grade haematolosical toxicity were9%(4/44) and 29%(20/68 in kazak and in han group,respectively(X2=6.57,P=0.037).Conclusions There was no significant difference in short-term curative effects between patients from han and kazak nationality with advanced carcinoma of esophagus who received the three-dimensional conformal radiotherapy combined with chemotherapy.but Kazak people showed better tolerance.