希罗达同步三维适形放射治疗恶性肿瘤腹膜后淋巴结转移  

Concurrent xeloda and three-dimensional conformal radiotherapy for retroperitoneal lymph node metastases

作　　者：王巾帼[1] 李建彬[1] 张秀强[2] 张琳[1] 范廷勇[1] 卢洁[1] 

机构地区：[1]山东省肿瘤医院放疗科,山东济南250117 [2]山东大学齐鲁医院耳鼻咽喉科,山东济南250112

出　　处：《中华肿瘤防治杂志》2006年第10期778-780,共3页Chinese Journal of Cancer Prevention and Treatment

摘　　要：观察希罗达同步三维适形放疗治疗恶性肿瘤腹膜后淋巴结转移的近期疗效及毒副反应。回顾性分析入组接受治疗的恶性肿瘤腹膜后淋巴结转移患者82例的临床资料,其中单纯三维适形放疗(3DCRT)组(RT组)40例,3DCRT同步口服希罗达组(XRT组)42例。3DCRT分割剂量2～3Gy/次,5次/周,总剂量45～58Gy/15～29次3～6周。XRT组自放疗开始之日起口服希罗达1000mg,2次/d,直到放疗结束。XRT组CR率为16.6%,PR率为38.1%,总有效率为54.7%。RT组CR率为10.0%,PR率为15.0%,总有效率为25.0%。两组差异有统计学意义,z=-2.13,P=0.006。XRT组与RT组的3年总生存率分别为33.3%和19.1%,无肿瘤进展生存率分别为21.4%和16.6%,两组的中位生存期分别为19和14个月。XRT组Ⅱ～Ⅲ级骨髓抑制12例(30%)并有3例发生手足综合征(7.5%)。回顾性分析结果提示,希罗达同步三维适形放疗治疗恶性肿瘤腹膜后淋巴结转移疗效明显,提高了总生存率,毒副反应可以耐受。The objoctive of this study was to observe the efficacy and side effect of concurrent Xeloda and threedimensional conformal radiotherapy（3DCRT）for retroperitoneal lymph node metastases. Of 82 patients with retroperitoneal lymph node metastasis, 40 cases accepted only 3-dimensional conformal radiotherapy were divided into RT group and 42 cases accepted concurrent Xeloda and 3DCRT were divided into XRT group. The total dose of 3DCRT was 45-58Gy （2-3 Gy/f, 5 f/w）. Xeloda was administered 1 000 mg twice daily from the begining of radiotherapy to the end in XRT group. For the patients in XRT group, the rates of complete response, partial response and total response were 16.6%, 38. 1% and 54.7 %, respectively. For the patients in RT group, they were 10.0%, 15. 0~ and 25.0%, respectively. The significant difference between XRT and RT groups was found （z= -2.13, P= 0. 006）. The 3-year overall survival rate and disease-free survival rate in XRT group and RT group were 33.3%, 19.1% and 21.4%, 16.6%, respectively. The median survival time was 19 months and 14 months respectively. Three cases were suffered from foot-hand syndrome （7. 5%）, and myelosuppression （ Ⅱ - Ⅲ grade） were found in 13 cases （30.9%） in XRT group. In conclusion, concurrent Xeloda and 3DRT are effective and safe for patients with retroperitoneal lymph node metastasis and can improve the overall survival and disease-free survival.

关 键 词：腹膜后肿瘤/放射疗法 腹膜后肿瘤/药物疗法 腹膜后肿瘤/继发性 放射疗法 适形 淋巴转移 脱氧胞苷/治疗应用 

分 类 号：R735[医药卫生—肿瘤]