后程适形放疗联合羟基喜树碱同步化疗治疗食管癌的临床观察  

Clinical observation of three-dimensional conformal radiation therapy for post period concurrently combined with chemotherapy of 10-hydroxycamptothecin for esophageal carcinoma

作　　者：陈红[1] 岳力强 房芳[1] 肖颖[1] 张绍华[1] 孙晓东[1] 

机构地区：[1]唐山市工人医院肿瘤科,河北唐山063000 [2]乐亭县医院神经外科,河北乐亭063600

出　　处：《临床荟萃》2009年第7期587-589,共3页Clinical Focus

摘　　要：目的观察后程三维适形放疗（three-dimensional conformal radiation therapy, 3D-CRT）联合羟基喜树碱（ 10-hydroxycamptothecin, HCPT）同步化疗治疗食管癌的疗效及不良反应。方法90例患者随机分为放疗加化疗组（放化组）50例和单纯放疗组（放疗组）40例。两组前程均行普通二维放疗，在照射总剂量（total dose，DT）36～40Gy后，后程对食管病灶行3D-CRT，每次2Gy，每周5次，加量DT20～30Gy，至DT60～66Gy。放化组在放疗4周后，给予HCPT 6 mg／m^2静脉滴注，每日1次，连用7天同步化疗。结果放化组近期疗效明显优于放疗组（u_c=2．102，P〈0．05）。放化组1、3年生存率明显高于放疗组（70．0％VS47．5％和38．0％ vs 15．0％，均P〈0.05）；放化组与放疗组白细胞下降、恶心呕吐、放射性食管炎的发生率差异均无统计学意义（P〉0．05）。结论后程3D-CRT联合HCPT同步化疗治疗食管癌可明显提高远、近期疗效，不良反应虽有所增加，但患者能耐受。Objective To evaluate the efficacy and the adverse reaction of the three-dimensional conformal radiation therapy （3D-CRT） for the post period concurrently combined with chemotherapy of 10-hydroxycamptothecin （HCPT） for esophageal carcinoma. Methods A total of 90 patients were randomly divided into radiochemotherapy group（ n = 50） and radiotherapy group（ n = 40）. In the early stage, both groups received common two-dimesional conformal radiation therapy. The total dose（DT） of the esophageal carcinoma irradiation was 36-40 Gy, in the later stage,the reduced field for the local lesion of esophageal carcinoma would be altered to 3D-CRT for the post period, whose method was 2 Gy a time,5 times a week. DT was added from 20-30 Gy to 60-66 Gy. The patients were given HCPT 6 mg per square meters by intravenous drip every day with synchnnization for 7 days after 4 weeks, radiotheheray period in radiochemotherapy group. Results The short-term outcome of the radiochemotherapy group and the radiotherapy group has statistic significance between two groups（ P〈0.05）. The 1-, 3- year survival rates of radiochemotherapy group were higher than those of radiotherapy group, respectively 70.0% vs 47.5%, 38.0% vs 15.0% （both P 〈0.05）. The complications such as leucopoenia, nausea, vomiting and radioaction esophagitis were more common in radiochemotherapy group than in other group （P 〉0.05）. Conclusion 3D-CRT concurrently combined with chemotherapy is rather active for locally advanced esophageal carcinoma in forward and short-term outcome. More side effects are observed in radiochemotherapy group,however,all the patients could tolerate them.

关 键 词：食管肿瘤 放射疗法 适形 药物疗法 

分 类 号：R735.1[医药卫生—肿瘤]