当代医学
噹代醫學
당대의학
CHINA CONTEMPORARY MEDICINE
2014年
19期
37-38,39
,共3页
庞晓泳%温尊北%谢地%梁敦波%陈海文
龐曉泳%溫尊北%謝地%樑敦波%陳海文
방효영%온존북%사지%량돈파%진해문
食管癌%三维适形放疗%紫杉醇%奈达铂
食管癌%三維適形放療%紫杉醇%奈達鉑
식관암%삼유괄형방료%자삼순%내체박
Esophageal carcinoma%Three-dimensional conformal radiotherapy%Paclitaxel%Nedaplatin
探讨三维适形放疗联合紫杉醇、奈达铂化疗治疗局部晚期食管癌的疗效及不良反应。方法选取2006年6月～2010年2月高州市人民医院收治的临床分期Ⅱ～Ⅲ期局部晚期食管癌患者91例，随机分为2组，均采用三维适形放疗，处方剂量6000～7000 cGy。观察组在放疗期间联合化疗：紫杉醇135mg/m2，d1，奈达铂25mg/m2，d1～3，28d为1周期，化疗共4周期，与放疗同期2周期，放疗结束后2周期。结果观察组和对照组近期有效率（CR+PR）分别为80.43%和60%(P＜0.05)；观察组和对照组l、2、3年局控率分别为82.6%、56.5%、43.5%和66.7%、40%、31.1%，差异有统计学意义(P＜0.05)；1、2、3年生存率分别为78.3%、50%、36.9%和60%、33.3%、24.4%，差异有统计学意义(P＜0.05)；观察组的胃肠道反应、白细胞减少及血小板减少发生率分别为58.7%、26.1%和8.7%，高于对照组的22.2%、4.4%和2.2%，差异有统计学意义（P＜0.05）。2组放射性食管炎发生率无统计学意义。结论三维适形放疗联合紫杉醇、奈达铂化疗治疗局部晚期食管癌的近、远期疗效均优于单纯放疗，不良反应增加，但患者耐受性良好，值得进一步研究。
探討三維適形放療聯閤紫杉醇、奈達鉑化療治療跼部晚期食管癌的療效及不良反應。方法選取2006年6月～2010年2月高州市人民醫院收治的臨床分期Ⅱ～Ⅲ期跼部晚期食管癌患者91例，隨機分為2組，均採用三維適形放療，處方劑量6000～7000 cGy。觀察組在放療期間聯閤化療：紫杉醇135mg/m2，d1，奈達鉑25mg/m2，d1～3，28d為1週期，化療共4週期，與放療同期2週期，放療結束後2週期。結果觀察組和對照組近期有效率（CR+PR）分彆為80.43%和60%(P＜0.05)；觀察組和對照組l、2、3年跼控率分彆為82.6%、56.5%、43.5%和66.7%、40%、31.1%，差異有統計學意義(P＜0.05)；1、2、3年生存率分彆為78.3%、50%、36.9%和60%、33.3%、24.4%，差異有統計學意義(P＜0.05)；觀察組的胃腸道反應、白細胞減少及血小闆減少髮生率分彆為58.7%、26.1%和8.7%，高于對照組的22.2%、4.4%和2.2%，差異有統計學意義（P＜0.05）。2組放射性食管炎髮生率無統計學意義。結論三維適形放療聯閤紫杉醇、奈達鉑化療治療跼部晚期食管癌的近、遠期療效均優于單純放療，不良反應增加，但患者耐受性良好，值得進一步研究。
탐토삼유괄형방료연합자삼순、내체박화료치료국부만기식관암적료효급불량반응。방법선취2006년6월～2010년2월고주시인민의원수치적림상분기Ⅱ～Ⅲ기국부만기식관암환자91례，수궤분위2조，균채용삼유괄형방료，처방제량6000～7000 cGy。관찰조재방료기간연합화료：자삼순135mg/m2，d1，내체박25mg/m2，d1～3，28d위1주기，화료공4주기，여방료동기2주기，방료결속후2주기。결과관찰조화대조조근기유효솔（CR+PR）분별위80.43%화60%(P＜0.05)；관찰조화대조조l、2、3년국공솔분별위82.6%、56.5%、43.5%화66.7%、40%、31.1%，차이유통계학의의(P＜0.05)；1、2、3년생존솔분별위78.3%、50%、36.9%화60%、33.3%、24.4%，차이유통계학의의(P＜0.05)；관찰조적위장도반응、백세포감소급혈소판감소발생솔분별위58.7%、26.1%화8.7%，고우대조조적22.2%、4.4%화2.2%，차이유통계학의의（P＜0.05）。2조방사성식관염발생솔무통계학의의。결론삼유괄형방료연합자삼순、내체박화료치료국부만기식관암적근、원기료효균우우단순방료，불량반응증가，단환자내수성량호，치득진일보연구。
Objective To evaluate the efficacy and toxicity of three- dimensional conformal radiotherapy combined with Paclitaxel plus Nedaplatin in the treatment of locally advanced esophageal carcinoma.Methods From June 2006 to February 2010,91 cases with StageⅡ andⅢ locally advanced esophageal carcinoma were randomized into the control group (Radiotherapy group) and the observe group (Concurrent chemoradiotherapy group). Two groups were treated by three-dimensional conformal radiotherapy. The control group was radiotherapy only with a total dose of 6000cGy to 7000cGy. The observe group was radiotherapy combined with 2 cycles chemotherapy with 135mg/m2 Paclitaxel on day 1 and 25mg/m2 Nedaplatin on days 1 to 3 every four weeks. 2 cycleschemotherapy was performed after radiotherapy.Results The overall response(CR + PR) rates of The observe group and the control group were 80.43% and 60% respectively(P<0.05). The 1, 2, 3 year local control rates of the observe group and the control group were 82.6%,56.5%,43.5% and 66.7%,40%,31.1%,respectively (P<0.05). The 1,2,3 year overall survival rate of the observe group and the control group were 78.3%,50%, 36.9% and 60%,33.3%,24.4%,respectively (P<0.05). The toxicity include gastrointestinal reaction, leukopenia and thrombocytopenia in the observe group were 58.7%、26.1% and 8.7% respectively comparing with 22.2%,4.4% and 2.2% respectively in the control group (P<0.05). However,there was no significant difference in radiation esophagitis between the two group.Conclusion The better short-term and long-term curative effect of locally advanced esophageal carcinoma could be achieved with concurrent chemoradiotherapy compared with radiotherapy alone. It is worthy for further research since most patients in observation group had high tolerance for the increasing toxicity.
