摘要
背景与目的:近年来研究发现中晚期食管癌术后放化疗能提高疗效,但不良反应少有专门报道,本研究目的是观察胸段食管鳞癌术后放化疗的不良反应及对策。方法:选择淋巴结阳性胸段食管鳞癌术后放化疗患者164例,术后放疗剂量50 Gy,化疗方案为顺铂联合紫杉醇,21 d为1个周期,观察其不良反应。结果:全组3年总生存率为65.7%,早期不良反应主要表现:①骨髓抑制,主要为白细胞下降,其中Ⅰ/Ⅱ度骨髓抑制共125例(76.2%),Ⅲ/Ⅳ度骨髓抑制共33例(20.1%);②脱发,Ⅰ/Ⅱ度共147例(89.6%);③肌肉或关节痛,Ⅰ/Ⅱ度共97例(59.1%);④胃肠道反应,Ⅰ/Ⅱ度共32例(19.5%),Ⅲ度6例(3.7%);⑤全组无明显肝肾功能异常及过敏反应;⑥放射性食管炎和放射性气管炎Ⅰ/Ⅱ度分别为61例(37.2%)和28例(17.1%)。晚期放疗损伤有肺损伤Ⅲ度8例(4.9%),肺损伤Ⅴ度1例(0.6%),吻合口狭窄1例(0.6%)。结论:胸段食管鳞癌术后放化疗的不良反应主要表现为白细胞下降、肌肉或关节痛以及胃肠道反应,患者均能耐受。
Background and purpose： Many studies have shown that postoperative chemoradiotherapy for middle stage and advanced esophageal carcinomas can improve treatment results in recent years, but few reported specially on the adverse effects. This study aimed to investigate the adverse effects of postoperative chemoradiotherapy for thoracic esophageal squamous carcinoma （EPC） and their counter measures. Methods： A total number of 164 patients with thoracic EPC and with positive lymph nodes underwent postoperative chemoradiotherapy. The irradiation dose was 50 Gy. The chemotherapy consisted of cisplatin and paclitaxel, and 1 cycle continued 21 days. Results： The 3-year overall survival rate was 65.7%. The early toxic responses mainly represented as following： ①Myelotoxicity principally showed leucopenia at grade 1/2 occurred in 125 patients （76.2%） and at grade 3/4 in 33 patients （20.1%）; ②Baldness at grade 1/2 occurred in 147 patients （89.6%）; ③Pain of muscles or arthralgia at grade 1/2 occurred in 97 patients （59.1%）; ④Responses of gastrointestinal tract at grade 1/2 occurred in 32 patients （19.5%） and at grade 3 in 6 patients （3.7%）; ⑤There was no obvious liver and renal function abnormal and allergy; ⑥Radiation induced esophagitis and tracheitis at grade 1/2 occurred in 61 patients （37.2%） and in 28 patients （17.1%） respectively. The late toxic responses of irradiation were pulmonary toxicity at grade 3 occurred in 8 patients （4.9%） and at grade 4 in one patients （0.6%）, and stenostomia occurred in 1 patient （0.6%）. Conclusion： The toxic responses of postoperative chemoradiotherapy in thoracic EPC mainly represented leucopenia, pain of muscles or arthralgia and responses of gastrointestinal tract, and they were tolerant.
出处
《中国癌症杂志》
CAS
CSCD
北大核心
2012年第8期605-608,共4页
China Oncology
关键词
食管肿瘤
外科学
放射疗法
化学疗法
不良反应
生存率
Esophageal neoplasms
Surgery
Radiotherapy
Chemotherapy
Side effects
Survival rate
