中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
8期
52-54
,共3页
食管肿瘤%放射疗法,调强适形%同期放化疗
食管腫瘤%放射療法,調彊適形%同期放化療
식관종류%방사요법,조강괄형%동기방화료
Esophageal neoplasms%Radiotherapy,intensity modulated%Chemoradiotherapy
目的 探讨调强适形放疗(IMRT)同期TP方案(多西他赛+顺铂)化疗治疗食管上段癌的疗效、局部控制率、生存率及不良反应.方法 78例食管上段癌患者以双盲法随机分为IMRT联合同期化疗组(放化组)和单纯IMRT组(放疗组),每组39例.放化组采用IMRT,总剂量6 400 cGy/32次,5次/周,同期应用TP方案化疗每周1次;放疗组单纯采用IMRT.观察分析各组近期疗效、局部控制率、生存率、不良反应.结果 放化组完全缓解17例,部分缓解20例,稳定2例,总有效率为94.9％(37/39);放疗组完全缓解9例,部分缓解19例,稳定11例,总有效率为71.8％(28/39).放化组总有效率高于放疗组,差异有统计学意义(P＜0.05).放化组3年局部控制率为69.2％(27/39),明显高于放疗组的35.9％(14/39),差异有统计学意义(P＜0.05).放化组3年生存率为74.4％(29/39),明显高于放疗组的43.6％(17/39),差异有统计学意义(P＜0.05).结论 IMRT同期TP方案化疗较单纯IMRT提高了近期疗效、局部控制率、生存率,其近期和远期不良反应可以耐受.
目的 探討調彊適形放療(IMRT)同期TP方案(多西他賽+順鉑)化療治療食管上段癌的療效、跼部控製率、生存率及不良反應.方法 78例食管上段癌患者以雙盲法隨機分為IMRT聯閤同期化療組(放化組)和單純IMRT組(放療組),每組39例.放化組採用IMRT,總劑量6 400 cGy/32次,5次/週,同期應用TP方案化療每週1次;放療組單純採用IMRT.觀察分析各組近期療效、跼部控製率、生存率、不良反應.結果 放化組完全緩解17例,部分緩解20例,穩定2例,總有效率為94.9％(37/39);放療組完全緩解9例,部分緩解19例,穩定11例,總有效率為71.8％(28/39).放化組總有效率高于放療組,差異有統計學意義(P＜0.05).放化組3年跼部控製率為69.2％(27/39),明顯高于放療組的35.9％(14/39),差異有統計學意義(P＜0.05).放化組3年生存率為74.4％(29/39),明顯高于放療組的43.6％(17/39),差異有統計學意義(P＜0.05).結論 IMRT同期TP方案化療較單純IMRT提高瞭近期療效、跼部控製率、生存率,其近期和遠期不良反應可以耐受.
목적 탐토조강괄형방료(IMRT)동기TP방안(다서타새+순박)화료치료식관상단암적료효、국부공제솔、생존솔급불량반응.방법 78례식관상단암환자이쌍맹법수궤분위IMRT연합동기화료조(방화조)화단순IMRT조(방료조),매조39례.방화조채용IMRT,총제량6 400 cGy/32차,5차/주,동기응용TP방안화료매주1차;방료조단순채용IMRT.관찰분석각조근기료효、국부공제솔、생존솔、불량반응.결과 방화조완전완해17례,부분완해20례,은정2례,총유효솔위94.9％(37/39);방료조완전완해9례,부분완해19례,은정11례,총유효솔위71.8％(28/39).방화조총유효솔고우방료조,차이유통계학의의(P＜0.05).방화조3년국부공제솔위69.2％(27/39),명현고우방료조적35.9％(14/39),차이유통계학의의(P＜0.05).방화조3년생존솔위74.4％(29/39),명현고우방료조적43.6％(17/39),차이유통계학의의(P＜0.05).결론 IMRT동기TP방안화료교단순IMRT제고료근기료효、국부공제솔、생존솔,기근기화원기불량반응가이내수.
Objective To evaluate the efficacy,local control rate,survival rate and adverse reaction of intensity modulated radiation therapy (IMRT) combind with Tp concurrent chemoradiotherapy (docetaxel and cisphtin) for superior segment of esophageal cancer.Methods Seventy-eight patients with superior segment of esophageal cancer were divided randomly into IMRT combined with TP concurrent chemoradiotherapy group (chemoradiotherapy group) and single IMRT group (radiotherapy group) by double blind method with 39 cases each.The patients in chemoradiotherapy group received chemoradiotherapy,while other patients in radiotherapy group received only radiotherapy.For both groups,the same radiation technic was given with chemoradiotherapy,the total dose was 6 400 cGy/32 f.For the patients in chemoradiotherapy group were also given with TP concurrent chemotherapy weekly.The efficacy,local control rate,survival rate and adverse reaction was observed.Results Complete remission in 17 cases,partial remission in 20 cases,stable in 2 cases,the total effective rate was 94.9％ (37/39) in chemoradiotherapy group.Complete remission in 9 cases,partial remission in 19 cases,stable in 11 cases,the total effective rate was 71.8％ (28/39) in radiotherapy group.There was significant difference in the total effective rate between two groups(P ＜ 0.05).The 3-year local control rate was 69.2％ (27/39) in chemoradiotherapy group,which was higher than that in radiotherapy group[35.9％(14/39)],and there was significant difference(P ＜ 0.05).The 3-year survival rate was 74.4％(29/39) in chemoradiotherapy group,which was higher than that in radiotherapy group [43.6％(17/39)],and there was significant difference (P ＜0.05).Conclusion IMRT combined with TP concurrent chemoradiotherapy can improve the efficacy,local control me,survival rate of esophageal cancer,but can also increase the acute toxic effect.
