含铂类为基础化疗联合放疗治疗完全梗阻性食管癌  

Cisplatin-based Sequential Chemoradiotherapy for the Complete Obstructive Esophageal Carcinoma.

作　　者：李兴保[1] 纪华清[1] 

机构地区：[1]安徽省铜陵市人民医院放疗科,244000

出　　处：《医学研究杂志》2007年第2期45-48,共4页Journal of Medical Research

摘　　要：目的通过化、放续贯治疗手段解决完全梗阻性食管癌进食梗阻症状，完成放射治疗。提高局部控制率，延长生存期。方法回顾分析1999年4月-2003年10月本院收治完全梗阻性食管癌21例，占全部放射治疗食管癌病例2．4％，这21例完全梗阻性食管癌均为胸段食管癌，完全不能进食时间3～10天。分为两组：10例单纯放疗组，11例为化、放疗续贯治疗组。10例单纯放疗采用常规分割放疗。每次180～200cGy／F，每周5次。另11例采用先化疗，“DF”方案8例，“NP”方案3例，在化疗后12—18天进行放射治疗。放疗为常规分割放疗。分割剂量、方法同单纯放疗组。结果10例单纯放疗组有9例在放疗开始后1～4周，因进食梗阻症状不能改善终止放疗。有1例放疗6周，10例均不能改善进食症状。分别在接受放疗后1—2个月内死亡。中位生存期40天。另11例化疗、放疗综合治疗组在化疗后1～7天，11例均能改善进食梗阻。除1例在化疗后第3周因全身情况差未完成放疗，余10例均完成放疗。放疗期和放疗后全身情况相对差。血液性毒性相对大，中位生存期14个月。两组治疗有显著性差异。P〈0．0001。结论完全梗阻性食管癌单纯放疗疗效不佳。用先化疗缓解进食梗阻症状效果好。再通过放射治疗控制肿瘤生长，提高局部控制率，延长生存期。Objective In order to finish radiotherapy, improve local control rate and prolong survival period, dysphagia of complete obstructive esophageal carcinoma was treated by sequential chemo - radiotherapy. Methods From Apr. 1999 to Oct. 2003, the 21 patients of complete obstructive esophageal carcinoma were analysed retrospectively. The 21 patients were thoracic esophageal carcinoma,which accounted for 2.4% in all of esophageal cancinoma patients treated by radiotherapy in the same period. They were divided into two groups： 10 patients in group R received radiotherapy only, while 11 patients in group C ＋ R received chemo - radiotherapy . For both groups, the same radiation technic was carried out by conventional fractionation, 180 -200cGy/F,five times every week. For group C ＋ R, 8 cases were treated with DF chemotherapy regimen, 3 with NP. 12 - 18 days After chemotherapy, radiotherapy was followed. Results In group R, 9 cases give up radiotherapy because dysphagia was not improved, one case was treated six weeks. Dysphagia was not improved in the ten patients. They died within 1 - 2 months from beginning of radiotherapy. Median overall survival was 40 days. In group C ＋ R, Dysphagia was improved in the 11 patients from 1 -7 days after chemotherapy. 10 patients finished radiotherapy apart from one whose life quality was poor. The quality of life was comparatively poor during and after radiotherapy. Myelosuppression was comparatively severe. Median overall survival was 14 months. There was statistically singnificant difference in two groups （ P 〈 0.001 ）. Conclusions Complete obstructive esophageal carcinoma treated with radiotherapy alone had lower efficacy. Radiotherapy could control the growth of carcinoma, improve local control rate and prolong survival period after chemotherapy had improved dysphagia.

关 键 词：食管癌 完全性梗阻 化疗/放射治疗 

分 类 号：R735.105[医药卫生—肿瘤]