摘要
目的:探讨中晚期食管癌每周应用小剂量紫杉醇同步放化疗治疗的疗效及毒副反应。方法:63例中晚期食管癌患者,随机分成两组(放化组和单放组),放化组32例,单放组31例。两组均采用6MV-X射线三维适形放射治疗,总剂量60～66Gy/6～6.6周。放化组放疗第1天开始同时给予紫杉醇40mg/m2,每周给药1次,连用6周。结果:近期疗效放化组完全缓解(CR)56.25%、部分缓解(PR)34.38%、稳定(SD)6.25%和病情进展(PD)3.13%,单放组CR38.71%、PR 25.81%、SD 19.35%和PD 16.13%,差异有统计学意义,P<0.05。放化组与单放组的1、2、3年生存率分别为75.0%、56.3%、28.1%和64.5%、32.3%、16.1%,总生存率差异有统计学意义,P<0.05;1、2、3年无进展生存率分别为65.6%、43.8%、18.8%和41.9%、19.4%、12.9%,差异有统计学意义,P<0.05。放化疗组的放射性食管炎、黏膜炎、恶心和血液毒性高于单放疗组。结论:同步放化疗可提高局部晚期食管癌的有效率、总生存率,降低远处转移率,部分毒副反应增加,但患者能够耐受。
OBJECTIVE： To observe the efficacy and toxicity of weekly paclitaxel concurrent radiochemotherapy for advanced esophageal carcinoma. METHODS： Total 63 patients with advanced esophageal cancer were randomly divided into two groups, 32 patients in radiochemotherapy group received concurrent radiochemotherapy, while 31 patients in single radiotherapy group received only radiotherapy, for both groups, the same radiation technic was given with 3-dimensional conformal radiation therapy （3DCRT） with 6 MV X ray,the total dose was 60-66 Gy/（6- 6.6） weeks, for patients in radiochemotherapy group were also given with concurrent chemotherapy （paclitaxel 40 mg/m2 d1 ,one time per week for six weeks）. RESULTS： The complete remission（CR）, partial remission （PR）, stable disease（ SD）, progression diseae （PD） of radiochemotherapy group were 56.25%,34.38% ,6.25% ,3.13% respectively,while the single radiotherapy group were 38. 71%,25. 81% ,19. 35%,16. 13%,the difference between the two groups was statistically （P〈0.05）. The one, two and three year survival rate were 75.0%,56.3% and 28.1% in radiochemotherapy group, while survival rate were 64. 5%, 32. 3% and 16. 1% in single radiotherapy group, the difference of survival rates between the two groups was statistically （P〈0.05）. The one, two, three year progression-free survival were 65. 6 %, 43. 8%, 18.8% in radiochemotherapy group while 41. 9%, 19. 4%, 12. 9% in single radiotherapy group respectively, and the difference between the two groups was statistically （P〈0.05）. Toxic and adverse effects were more serious in radiochemotherapy group than that in single radiotherapy group, however all patients were well-tolerated. CONCLUSION： Weekly paclitaxel concur rent radiochemotherapy for advanced esophageal cancer may be a more effective, longer overall survival, longer progression-free survival, and it also increases the acute toxicity but is tolerable.
出处
《中华肿瘤防治杂志》
CAS
2011年第20期1635-1638,共4页
Chinese Journal of Cancer Prevention and Treatment
关键词
食管肿瘤/药物疗法
食管肿瘤/放射疗法
综合疗法
esophageal neoplasms/drug therapy
esophageal neoplasms/radiotherapy
combined modality therapy
