CAJ | 학술논문

目的：探讨替吉奥同步放化疗治疗中晚期食管胃结合部癌的疗效及不良反应。方法48例中晚期食管胃结合部癌患者，随机分成2组：同步组25例和单放组23例。2组均采用6MV-X射线三维适形放射治疗，总剂量6000 cGy/6周。同步组放疗第1天同时口服替吉奥胶囊，早晚各1次，14 d为1个周期，停药7 d后进行下1个周期。结果同步组剔除1例。近期疗效同步组有效率（ ORR）为74．9％，单放组ORR为39．1％，差异有统计学意义（χ2＝4．801， P ＜0．05）。同步组与单放组的1、2年生存率分别为72．0％、40．0％和69．6％、39．1％（χ2＝0．034， P ＞0．05）；1、2年无进展生存率分别为56．0％、24．0％和52．2％、21．7％（χ2＝0．071， P ＞0．05），差异均无统计学意义。2组不良反应主要有放射性食管炎、放射性肺炎和骨髓抑制，同步组的发生率较单放组高，但差异无统计学意义（P ＞0．05），经对症处理后患者耐受良好。结论替吉奥联合三维适形放疗治疗中晚期食管胃结合部癌安全、有效，值得进一步扩大样本研究。
목적：탐토체길오동보방화료치료중만기식관위결합부암적료효급불량반응。방법48례중만기식관위결합부암환자，수궤분성2조：동보조25례화단방조23례。2조균채용6MV-X사선삼유괄형방사치료，총제량6000 cGy/6주。동보조방료제1천동시구복체길오효낭，조만각1차，14 d위1개주기，정약7 d후진행하1개주기。결과동보조척제1례。근기료효동보조유효솔（ ORR）위74．9％，단방조ORR위39．1％，차이유통계학의의（χ2＝4．801， P ＜0．05）。동보조여단방조적1、2년생존솔분별위72．0％、40．0％화69．6％、39．1％（χ2＝0．034， P ＞0．05）；1、2년무진전생존솔분별위56．0％、24．0％화52．2％、21．7％（χ2＝0．071， P ＞0．05），차이균무통계학의의。2조불량반응주요유방사성식관염、방사성폐염화골수억제，동보조적발생솔교단방조고，단차이무통계학의의（P ＞0．05），경대증처리후환자내수량호。결론체길오연합삼유괄형방료치료중만기식관위결합부암안전、유효，치득진일보확대양본연구。
Objective To investigate the effect and adverse reaction of Tijiao capsules(S-1) capsule plus radiothera-py on advanced esophageal and gastric cancer in gastro-esophageal junction .Methods 48 cases of advanced esophageal and gastric cancer were randomly divided into 2 groups:25 cases in synchronous group and solo radiotherapy group of 23 cases re-spectively.Two groups were treated by 6MV X-ray three dimensional conformal radiotherapy , total dose of 6 000 cGy/6 weeks.Synchronous radiotherapy group first days with oral S-1,bid, 14 d for 1 courses, 7 d after stop taking S-1 to start the next cycles.Results Except 1 case in synchronous group, the efficacy of synchronous group (ORR) was 74.9%, ORR of solo radiotherapy group was 39.1% respectively, the difference was statistically significant (χ2 =4.801, P <0.05).1st, 2nd year survival rates of synchronous group and solo radiotherapy group were 72.0%,40.0%,69.6% and 39.1% (χ2 =0.034, P >0.05); 1st, 2nd years progression free survival rates of synchronous group and solo radiotherapy group were 56.0%,24.0%,52.2%and 21.7%(χ2 =0.071, P >0.05), no statistical significance difference were found .Adverse re-actions of the 2 groups mainly are radiation esophagitis , radiation pneumonitis and bone marrow suppression , synchronous group occurred frequently than radiotherapy group , but the difference was not statistically significant ( P >0.05), patients showed good tolerance after symptomatic treatment .Conclusion The S-1 combined with three dimensional conformal radiothe-rapy in treatment of advanced esophageal and gastric cancer were safety ,effective,worthy of further study with larger sample .