中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2013年
9期
842-845
,共4页
吉福志%朱卫国%于长华%陶光州%潘鹏%周锡垒%李涛
吉福誌%硃衛國%于長華%陶光州%潘鵬%週錫壘%李濤
길복지%주위국%우장화%도광주%반붕%주석루%리도
食管肿瘤%调强放疗%化疗%预后%不良反应
食管腫瘤%調彊放療%化療%預後%不良反應
식관종류%조강방료%화료%예후%불량반응
Esophageal neoplasms%Intensity-modulated radiation therapy%Chemotherapy%Prognosis%Side effects
目的 比较调强放疗(IMRT)联合多西他赛加顺铂方案化疗(IMRT-TP)与单纯IMRT治疗Ⅱ～Ⅲ期食管癌的疗效及不良反应.方法 前瞻性入组2004年9月至2008年4月间在南京医科大学附属淮安第一医院住院治疗的170例Ⅱ～Ⅲ期食管癌,按随机数字表法分为IMRT组(85例)和IMRT-TP组(85例).两组患者均采用6 MV-X线全程实施调强放疗,IMRT-TP组放疗剂量为60 Gy/30次,IMRT组放疗剂量为66 Gy/30次,IMRT-TP组同步进行2个周期TP方案(多西他赛加顺铂)化疗.结果 IMRT-TP组有10例患者中途退出研究,最终IMRT-TP组入组75例,IMRT组入组85例.5例患者(3.1％,IMRT-TP组3例,IMRT组2例)失访,中位随访时间为45.5月.与IMRT组相比,IMRT-TP组总复发率[69.3％(52/75)比84.7％(72/85),P=0.020]和局部复发率[50.7％(38/75)比67.1％(57/85),P=0.035]明显降低,5年总生存率(29.3％和15.3％,P=0.031)和5年无复发生存率(24.0％和10.6％,P=0.015)明显增高,但3～4级不良反应发生率也明显升高[54.7％(41/75)比4.7％(4/85),P=0.000].结论 调强放疗联合多西他赛加顺铂方案化疗较单纯调强放疗能明显降低Ⅱ～Ⅲ期食管癌局部复发率,提高总生存率和无复发生存率,但不良反应也会明显增加.
目的 比較調彊放療(IMRT)聯閤多西他賽加順鉑方案化療(IMRT-TP)與單純IMRT治療Ⅱ～Ⅲ期食管癌的療效及不良反應.方法 前瞻性入組2004年9月至2008年4月間在南京醫科大學附屬淮安第一醫院住院治療的170例Ⅱ～Ⅲ期食管癌,按隨機數字錶法分為IMRT組(85例)和IMRT-TP組(85例).兩組患者均採用6 MV-X線全程實施調彊放療,IMRT-TP組放療劑量為60 Gy/30次,IMRT組放療劑量為66 Gy/30次,IMRT-TP組同步進行2箇週期TP方案(多西他賽加順鉑)化療.結果 IMRT-TP組有10例患者中途退齣研究,最終IMRT-TP組入組75例,IMRT組入組85例.5例患者(3.1％,IMRT-TP組3例,IMRT組2例)失訪,中位隨訪時間為45.5月.與IMRT組相比,IMRT-TP組總複髮率[69.3％(52/75)比84.7％(72/85),P=0.020]和跼部複髮率[50.7％(38/75)比67.1％(57/85),P=0.035]明顯降低,5年總生存率(29.3％和15.3％,P=0.031)和5年無複髮生存率(24.0％和10.6％,P=0.015)明顯增高,但3～4級不良反應髮生率也明顯升高[54.7％(41/75)比4.7％(4/85),P=0.000].結論 調彊放療聯閤多西他賽加順鉑方案化療較單純調彊放療能明顯降低Ⅱ～Ⅲ期食管癌跼部複髮率,提高總生存率和無複髮生存率,但不良反應也會明顯增加.
목적 비교조강방료(IMRT)연합다서타새가순박방안화료(IMRT-TP)여단순IMRT치료Ⅱ～Ⅲ기식관암적료효급불량반응.방법 전첨성입조2004년9월지2008년4월간재남경의과대학부속회안제일의원주원치료적170례Ⅱ～Ⅲ기식관암,안수궤수자표법분위IMRT조(85례)화IMRT-TP조(85례).량조환자균채용6 MV-X선전정실시조강방료,IMRT-TP조방료제량위60 Gy/30차,IMRT조방료제량위66 Gy/30차,IMRT-TP조동보진행2개주기TP방안(다서타새가순박)화료.결과 IMRT-TP조유10례환자중도퇴출연구,최종IMRT-TP조입조75례,IMRT조입조85례.5례환자(3.1％,IMRT-TP조3례,IMRT조2례)실방,중위수방시간위45.5월.여IMRT조상비,IMRT-TP조총복발솔[69.3％(52/75)비84.7％(72/85),P=0.020]화국부복발솔[50.7％(38/75)비67.1％(57/85),P=0.035]명현강저,5년총생존솔(29.3％화15.3％,P=0.031)화5년무복발생존솔(24.0％화10.6％,P=0.015)명현증고,단3～4급불량반응발생솔야명현승고[54.7％(41/75)비4.7％(4/85),P=0.000].결론 조강방료연합다서타새가순박방안화료교단순조강방료능명현강저Ⅱ～Ⅲ기식관암국부복발솔,제고총생존솔화무복발생존솔,단불량반응야회명현증가.
Objective To compare the efficacy and toxicity of intensity-modulated radiation therapy plus chemotherapy(IMRT-TP) with simple intensity-modulated radiation therapy(IMRT) in the treatment of locally advanced esophageal carcinoma.Methods A total of 170 eligible patients with locally advanced esophageal carcinoma were recruited prospectively from September 2004 to April 2008 and randomly divided into IMRT-TP group and IMRT group.Two groups were treated with IMRT of 6MV-X.The radiation dose was 60 Gy in 30 fractions in IMRT-TP group and 66 Gy in 30 fractions in IMRT group.The regimen of chemotherapy consisted of docetaxel and cisplatin in IMRT-TP group for 2 cycles.Results Of 170 patients,160 completed the trial,including 75 patients of IMRT-TP group and 85 of IMRT group.As compared to IMRT group,total recurrence rate [69.3％(52/75) vs.84.7％(72/ 85),P=O.020] and local recurrence rate [50.7％(38/75) vs.67.1％(57/85),P=0.035] decreased in IMRT-TP group,the 5-year overall survival (29.3％ vs.15.3％,P=0.031) and 5-year recurrence free survival (24.0％ vs.10.6％,P=0.015) increased in IMRT-TP group.While severe side effect ratio increased obviously in IMRT-TP group [54.7％(41/75) vs.4.7％(4/85),P=0.000].Conclusion As compare to simple IMRT,IMRT plus docetaxel and cisplatin can decrease the local recurrence rate,prolong the overall survival and regression-free survival,but bring more side effects.
