放疗联合方克顺铂同步或序贯化疗治疗老年晚期食管癌的临床研究  

A Study of Concurrent Versus Sequential Chemoradiotherapy with Tegafur and Cisplatin for Old Patients with Locally Advanced Esophageal Carcinoma

作　　者：侯良宝[1] 贾秋龙 刘彦中[1] 王清[1] 梁卫宏[1] 

机构地区：[1]河南第一荣康医院放疗科,河南新乡453003 [2]新乡市传染病医院,河南新乡453001

出　　处：《肿瘤基础与临床》2009年第1期40-42,共3页journal of basic and clinical oncology

摘　　要：目的评价放疗联合方克顺铂同步或序贯化疗治疗老年食管癌的疗效及毒副反应。方法将62例>70岁的老年食管癌随机分成两组:同步放化疗组(31例),放疗第1天即同时开始化疗;序贯放化疗组(31例),入组后先予化疗2个周期,再单独予放疗,放疗结束后再化疗2～3个周期,放疗采用60Coγ线,常规分割放疗,1.8～2.0Gy/次,5次/周,总剂量64～68Gy/6～7周完成。结果同步组和序贯组的有效率分别为93.5%、83.9%,1、3年局部控制率分别为77.4%与67.7%和48.4%与38.7%,两组比较差异无统计学意义(χ2=3.02,P>0.05)。同步组和序贯组的1、3年生存率分别为74.2%与64.5%和45.2%与32.3%,两组比较差异无统计学意义(χ2=2.32,P>0.05)。同步组的血液学毒性、放射性食管炎以及放射性肺炎均高于序贯组,多数为1～2级。结论老年晚期食管癌患者同步治疗组较序贯治疗组的疗效提高,生存期延长,毒副反应增加,但患者可以耐受。Objective To compare the effect and the clinical toxicity of concurrent and sequential chemo-radiotherapy（CRT） with tegafur and cisplatin for old patients with locally advanced esophageal carcinoma. Methods Sixty-two patients over seventy years old with locally advanced esophageal carcinoma were randomly assigned to two groups： Concurrent CRT group （31 cases）, when radiotherapy（RT） was started, chemotherapy（CT） was started on the first day; equential CRT group（31 cases） , accepted 2 cycles CT before RT, when RT was finished, then accepted 2 -3 cycles CT, all patients were treated by ^60Co γ ray, conventional fractionation radiotherapy 1. 8 -2.0 Gy/f, 5 f/ w, the total doses were 64 -68 Gy/6 -7 weeks. Results The concurrent and sequential CRT group overall response rates separately were 93.5% , 83.9% , 1-, 3-year local control rates in the concurrent CRT group were 77.4% and 67.7% , in the sequential CRT group were 48.4% and 38.7% , no difference was found in the two groups （Χ^2=3.02,P 〉0.05）. The 1-year and 3-year survival rates were 74.2% , 64.5% in the concurrent CRT group, and 45.2% , 32.3% in the sequential CRT group. No difference was found in the two groups （Χ^2= 2.32, P 〉 0. 05）. Blood cell decline and esophageal toxicity were significantly more frequent in the concurrent CRT group than those in the sequential CRT group （P 〉 0.05）. However, the toxicities were tolerable by treatment. Conclusion Compared concurrent and sequential CRT groups of locally advanced esophageal carcinoma, the efficacy was improved and the survival time was lengthened and side effects were increased but tolerable.

关 键 词：食管肿瘤 放射疗法 化学疗法 预后 

分 类 号：R730.55[医药卫生—肿瘤] R735.1[医药卫生—临床医学]