摘要
目的：观察调强适形放疗（intensitymodulatedradiationtherapy，IMRT）联合多西他赛、奈达铂方案化疗同步治疗局部晚期食管癌的疗效及安全性。方法：选择66例局部晚期食管癌患者为研究对象，将其随机分为2组，其中常规放疗组（A组）共30例，采用常规照射方法，6／8MV高能x线，2．0Gy／次，5次／周；40Cy／20次后再次定位剂量达60-66Gy，强调放疗组（B组）共36例，采用强调适应性放疗，6／8MV—X射线照射，以95％等剂量线包绕PTV（计划靶区），处方剂量GTV（肿瘤区）66Gy／30次，cTV（临床靶区）60Gy／30次，PTV60Gy／30次，每天1次，每周5次。强调放疗组同期接受IMRT和多西他赛、柰达伯化疗，21天1个周期，连续2个周期。治疗结束后根据实体瘤疗效评价标准（RECAST）评定临床疗效；参照WHO毒性反应分度标准评价毒副反应。结果：常规放疗组和强调放疗组的总有效率分别为46．66％和91．67％（xZ=17．26，P〈0．05）；常规放疗组的毒副反应发生率显著高于强调放疗组，包括骨髓抑制、放射性食管炎和消化道反应的发生率存在显著差异（P〈O．05）。结论：调强适形放疗联合多西他赛、奈达铂化疗同步治疗局部晚期食管癌疗效较好，毒副反应可耐受，具有潜在的推广应用价值，值得临床进一步研究。
Objective： To observe the clinical effects of intensity modulated radiation therapy （IMRT） combined docetaxe and nedaplatin chemotherapy for local advanced esophageal cancer, Methods： Totally 66 patients with local advanced esophageal cancer were enrolled in this study. Thirty patients enrolled in group A （n=30） received conventional radiotherapy. External beam radiation of 6/8MV-X ray was given 2.0 Gy/time and 5 time / week. A total dose of 60-66 Gy was reset after 40 Gy/20 times. Thirty-six patients en- rolled in group B （n=36） received IMRT with external beam radiation of 6/8MV-X ray and PTV received 95% of total dose radiation. GTV received a dose of 66 Gy/30 times, CTV received a dose of 60 Gy/30 times and PTV received a dose of 60 Gy/30 times. Patients were treated once a day and 5 times/week and combined with docetaxe and nedaplatin chemotherapy. After two cycles of chemotherapy, the clinical efficacy was evaluated according to the standards of response evaluation criteria in solid tumors （RECIST）; toxic side effects were measured referring to the standards of WHO. Results： The clinical efficacy of all the patients could be evaluated, of which the total effective rate was 46.66% in group A and 91.67% in group B （xZ=-17.26, P〈0.05）. The main toxic and side effects included myelosup- pression, radiation esophagitis and digestive tract reactions, which were all significantly severer in group A than those in group B （P〈0. 05）. Conclusion： IMRT combined docetaxe and nedaplatin chemotherapy has shown satisfactory efficacy and safety in treating local advanced esophageal cancer which has the potential for extensive application and is deserved further clinical research.
出处
《现代生物医学进展》
CAS
2014年第5期892-894,943,共4页
Progress in Modern Biomedicine
关键词
局部晚期食管癌
调强适形放疗
多西他赛
奈达铂
Local advanced esophageal cancer
Intensity modulated radiation therapy
Docetaxe
Nedaplatin
