摘要
目的观察三维适形再程放疗同步联合奈达铂加氟尿嘧啶（5-Fu）治疗放疗后局部复发食管癌患者的疗效及副反应。方法54例放疗后局部复发的食管癌患者，随机分成两组：研究组27例，行三维适形再程放疗（50～56Gy／25～28F）同步联合奈达铂80mg／（m^2·d），静脉滴注，第1天加5-FU350mg／（m^2·d），第1—5天化疗；于放疗中及放疗后配合奈达铂加5一Fu化疗。对照组27例，行三维适形再程放疗（50—56Gy／25～28F）序贯联合奈达铂80mg／（m^2·d），静脉滴注，第1天加5-FU350mr／（m^2·d）d1。5）化疗；于放疗后使用奈达铂加5-FU化疗。两组患者化疗均3～4周为1个周期，共2—4个周期。结果（1）两组近期疗效：研究组与对照组的近期疗效（CR＋PR）分别为59．2％（16／27）和55．5％（15／27），两组比较差异无统计学意义（x^2=0．076，P=0．5）。（2）生存率：研究组与对照组的1、2、3年生存率分别为54．2％、26．4％、15．7％和40．3％、19．7％、10．8％，两组比较差异有统计学意义（x^2=6．87，P=0．032）。（3）毒副反应：研究组血液系统毒副反应高于对照组，差异有统计学意义（x^2=5．882，P=0．043）；两组非血液系统毒副反应差异无统计学意义（x^2=4．25，P=0．75）。（4）放射性食管炎：两组差异无统计学意义（x^2=0．869，P=0．661）。结论三维适形再程放疗同步联合奈达铂与5-Fu化疗对放疗后复发食管癌有较好疗效，可提高生存率。
Objective To evaluate the therapeutic effect and side effects of three-dimensional conformal re-irradiation combined with nedaplation plus 5-fluorouracil synchronously in treatment of recurrent esophageal carcinoma. Methods Fifty-four patients with reeurrentesophageal carcinoma were randomly divided into two groups ： study group with 27 patients who were treated with three-dimensional eonformal re-irradiation （ 50 - 56 Gy/25 -28 F） combined with chemotherapy synchronously and control group with 27 patients who were treated with re-irradiation （50 - 56 Gy/25 - 28 F）combined with chemotherapy orderly. The patients of study group were treated with nedaplation80 rag/（ m2 · d）plusS-FU 350 mg/（ m2 · d）, from 1 to 5 day synchronously in radiotherapy and after radiotherapy. The patients of control group were treated with nedaplation80 mg/（ m2 · d） plus 5-FU 350 mg/（m2 · d）d from 1 to 5 day orderly after radiotherapy. The patients were treated every 3 -4 weeks as a cyele with total 2 - 4 cycles in these two groups. Results （ 1 ） The short-term effect： the short-term effeet（CR ＋ PR） of the two groups were 59. 2% （ 16/27 ） and 55. 5% （ 15/27 ） respectively, there was no statistical difference between the two groups（ X2 = 0. 076, P = O. 5 ）. （ 2 ） The survival rate ： the survival rate of one,two and three years were 54. 2% ,26. 4% ,15. 7% in study group and 40. 3% ,19. 7% ,10. 8% in control group respectively. The survival rate in study group was significantly higher than that in control group （ X2 = 6. 87 ,P = 0. 032 ）. （3）The study of side effects：there was significant difference on the hematologic toxicity between the study group and the control group （ X2 = 5. 882 ,P = 0. 043 ）. And there was no significant difference on the non-hematologic toxicity between the two groups （X2 = 4. 25, P = 0.75 ）. （4）The acute radiationesophagitis ：There was no statistical difference on radiation-esophagitis between the two groups（ X2 = 0. 869 ,P = 0. 661 ）. Conclusion Three-dimensional conformal re-irradiation combined with nedaplation plus 5-fluorouracil synchronously for recurrent esophageal carcinoma has a good efficacy and can also improve the survival rate.
出处
《中国综合临床》
2012年第3期311-314,共4页
Clinical Medicine of China
关键词
复发食管癌
放射治疗
药物治疗
Recurrent esophageal carcinoma
Radiotherapy
Chemotherapy
