奈达铂联合三维适形放射治疗晚期食管癌  

Clinical research of nedaplatin combined with 3-dimensional conformal radiotherapy for patients with advanced esophageal cancer

作　　者：郑伟[1] 郑家贺[2] 

机构地区：[1]中国医科大学附属盛京医院肿瘤科,辽宁沈阳110021 [2]中国医科大学附属盛京医院放射科,辽宁沈阳110021

出　　处：《中国新药与临床杂志》2008年第12期912-915,共4页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：目的探讨奈达铂(NDB)联合三维适形放射(3DCRT)方法治疗晚期食管癌的近期疗效、生存期及毒性反应。方法90例食管癌病人根据入选标准,随机分组,46例进入3DCRT+NDB组(试验组),44例进入单纯3DCRT组(对照组)。NDB按80～100 mg·m^(-2)+氯化钠注射液500 mL静脉滴注2h, d1,28d为一个周期,共行3个周期。先进行1个周期化疗后开始3DCRT,每次5～6 Gy,隔日照射1次,共7～8次,总剂量40～42 Gy(13～15d)。结果有效率试验组为91%,对照组为71%(P< 0.05);1、2、3年局部控制率试验组分别为76%、70%和50%,对照组分别为45%、34%和20% (P<0.05);1、2、3年生存率试验组分别为72%、59%和50%,对照组分别为41%、36%和25% (P<0.05)。试验组的白细胞下降及血小板减少发生率较对照组高(P<0.05;P<0.01),但病人均能耐受。结论以NDB单药联合3DCRT治疗能明显改善晚期食管癌生存率和局部控制率,虽不良反应增加但均能耐受。AIM To evaluate the short term response, survival and toxicity of nedaplatin （NDB） com- bined with 3-dimensional conformal radiotherapy （3DCRT） for patients with advanced esophageal cancer. METHODS Ninety patients with advanced esophageal cancer were randomly divided into two groups, 46 patients in trial group received nedaplatin and 3DCRT, while 44 patients in control group received radiotherapy only. For both groups, the same radiation technique was carried out by 3DCRT in which all were treated individually once every other day to a total dose of 40 - 42 Gy in 13 - 15 day at 5 - 6 Gy per fraction totally 7 - 8 fractions. For trial group, one and two cycles chemotherapy （NDB 80 - 100 mg-m-2＋NS 500 mL, iv drop, 2 h; d 1, d 28 as a cycle） were given individually before and after radiation therapy respectively. RESULTS Complete response rate in trial group was 91%, while in control group it was 71% （P 〈 0.05） . The 1, 2, 3 year local control rates in trial group were 76 %, 70 % and 50 %, while those in control group were 45 %, 34 % and 20 %, respectively （P 〈 0.05） . The 1, 2 and 3-year survival rates in trial group were 72 %, 59 % and 50 %, while those in control group were 41%, 36 % and 25 %, respeetively （P〈 0.05）. The toxic effect on bone marrow was greater in trial group than in control group （P 〈 0.05, P 〈 0.01 ） , but tolerable by all patients. CONCLUSION The combination of nedaplatin and 3DCRT can obviously improve the local control rate and survival rate for patients with advanced esophageal cancer, in spite of increasing side effects but tolerable for all patients.

关 键 词：食管肿瘤 放射疗法 药物疗法 预后 奈达铂 

分 类 号：R979.1[医药卫生—药品] R735.1[医药卫生—药学]