摘要
目的:三维适形放疗、周剂量奈达铂(NDP)增敏、体外高频热疗相结合,治疗中晚期食管癌,观察临床疗效、生存率、毒副反应。方法:将66例经病理证实的中晚期食管癌患者随机分成:放化疗组(n=33)和放化热疗组(n=33)。放化疗组:6MV-X医用电子直线加速器三维适形放疗,2.0Gy/次,5次/周,6-7周;与放疗同步行奈达铂(NDP)化疗,30-40mg静脉滴入,1次/周,共6次。放化热疗组:6MV-X医用电子直线加速器三维适形放疗,2.0Gy/次,5次/周,6-7周;与放疗同步行奈达铂(NDP)化疗,30-40mg静脉滴入,1次/周,共6次;放疗期间加用ZD-2001型体外电场高频热疗机进行深部热疗,2次/周,温度42.0℃-42.9℃,每次加热1h,共12次。治疗结束后3个月评估近期疗效和近期毒副反应,随访评估远期疗效。结果:放化疗组:CR 8/33例,PR 13/33例,SD 10/33例,PD 2/33例,总有效率63.6%;放化热疗组:CR 11/33例,PR 17/33例,SD 5/33例,PD 0/33例,总有效率84.8%,两组比较有统计学差异(P<0.05)。放化热疗组吞咽困难减轻87.9%(29/33),与放化疗组比较有统计学差异(P<0.05);体重增加78.8%(26/33),KPS评分增加81.8%(27/33),与放化疗组比较体重增加及KPS评分增加分别为18.2%、12.1%,但统计学差异不显著(P>0.05)。两组皮肤反应、放射性食管炎、放射性肺炎、骨髓抑制发生率比较无统计学差异(P>0.05)。放化热疗组1年生存率81.8%(27/33),放化疗组1年生存率57.6%(19/33),两组比较有统计学差异(P<0.05)。结论:三维适形放疗、周剂量奈达铂(NDP)增敏、体外高频热疗相结合,治疗中晚期食管癌有效率进一步提高,生存率延长,毒副反应不增加或减轻。
Objective：To observe the clinical curative effect, survival rate and adverse reaction of middle -ad- vanced stage esophageal carcinoma treated by combined three -dimensional conformal radiotherapy with weekly dose of nedaplatin and extraeorporeal high - frequency hyperthermia. Methods： All 66 cases of middle - advanced stage e- sophageal carcinoma confirmed by pathology were divided randomly into chemoradiotherapy group （n = 33 ） and hy- perthermochemoradiotherapy group（ n = 33 ）. Chemoradiotherapy group：three -dimensional eonformal radiotherapy by 6MV - X medical electron linear accelerator,2.0Gy/time, five times per week, 6 -7 weeks. Nedaplatin （NDP） , walk- ing with radiotherapy,30 - 40mg/time, intravenous drip, one time per week, six times. Hyperthermochemoradiothera- py： three -dimensional conformal radiotherapy by 6MV -X medical electron linear accelerator, 2.0Gy/time, five times per week ,6 - 7 weeks. Nedaplatin （NDP） , walking with radiotherapy, 30 - 40mg/time, intravenous drip, one time per week, six times. During the radiotherapy, plusd using ZD -2001 type high frequency thermotherapy machine to thermal therapy, 2 times/week, temperature from 42. 0℃ to 42.9 ℃, heated for one hour every time, 12 times. After three months of treatment, evaluated the curative effect and adverse reaction. Results： Chemoradiotherapy group ： CR 8/33 cases,PR 13/33 cases,SD 10/33 cases,PD 2/33 cases, total effective rate was 63.6%. Hyperthermochemora- diotherapy group ： CR 11/33 cases, PR 17/33 cases, SD 5/33 cases, PD 0/33 cases, total effective rate was 84.8% （P 〈 0.05 ）. Dysphagia reduce of hyperthermochemoradiotherapy group accounted for 87.9% （ 29/33 ）. Compared with the chemotherapy group, there were significant differences （P 〈 0. 05 ）. Weight gain accounted for 78.8% （26/ 33 ） , KPS score gain accounted for 81.8% （27/33）. Compared with the chemotherapy group, the weight gain and KPS score increased respectively by 18.2% and 12.1% ,but there was no statistically significant difference（ P 〉 0.05 ）. For skin reaction, radioactive esophagitis, radioactive pneumonia, bone marrow suppression, the incidence of two groups was no statistical difference （ P 〉 0.05 ）. One year survival rate of hyperthermochemoradiotherapy group was 81.8% （ 27/33 ） ; One year survival rate of chemoradiotherapy group was 57.6% （ 19/33 ） （ P 〈 0.05 ）. Conclusion： The treatment of three -dimensional conformal radiotherapy,weekly dose Nedaplatin （NDP） ,in combination with ex- tracorporeal high - frequency hyperthermia for middle - advanced stage esophageal was more effective, improved the survival rate. Adverse reaction did not increase or reduce.
出处
《现代肿瘤医学》
CAS
2013年第12期2715-2718,共4页
Journal of Modern Oncology
基金
承德市科学技术研究与发展计划项目(编号:20123140)
关键词
三维适形放疗
奈达铂化疗
热疗
食管癌
three - dimensional conformal radiotherapy
nedaplatin chemotherapy
hyperthermia
esophageal carcinoma
