伽玛刀联合化疗治疗高位食管癌疗效观察  

Clinical Observation of Upper Esophagus Carcinoma Treated with Gamma-Knife and Chemotherapy

作　　者：王卓敏[1] 李宏斌[1] 李迎春[1] 张小玉[1] 戴德银[1] 

机构地区：[1]解放军第452医院,四川成都610021

出　　处：《现代临床医学》2009年第6期416-418,共3页Journal of Modern Clinical Medicine

摘　　要：目的：探讨全身伽玛刀联合同步化疗治疗高位食管癌的近期、远期疗效及其毒副反应。方法：48例高位（颈段、上胸段）食管癌患者采用PCF方案（奥沙利铂＋亚叶酸钙＋氟脲嘧啶）全身化疗，21d为1个周期，自化疗d1开始实施伽玛刀治疗，总剂量40—50Gy，次数10～12次，边缘剂量300～420cGy，等剂量曲线55％-85％，每日治疗1次，伽玛刀治疗结束后按计划继续全身化疗至少2个周期。结果：48例患者均按计划完成治疗，急性毒副作用主要表现为胃肠道反应、骨髓抑制及周围神经毒性，绝大多数为0～Ⅱ°，急性放射性食管炎（Ⅰ°～Ⅱ°）的发生率低，无食管穿孔、放射性肺炎及放射性气管炎出现；总缓解率（CR＋PR）为91．7％，中位生存时间16．2个月，1年、2年、3年生存率分别为70．8％、39．6％、31．3％。结论：全身伽玛刀治疗联合PCF方案全身化疗治疗高位食管癌患者，毒副反应较轻，患者耐受性及依从性较好，且近期及远期疗效较满意。Objective：To observe the short -term and long- term clinical effects as well as the side -effects of upper esophagus carcinoma treated by Gamma - knife system conformal radiotherapy （ GKS - CRT ）. Methods： 48 cases of upper （ cervical and upper thoracic ） esophagus carcinoma patients were treated with PCF chemotherapy regimen （ L - OHP ＋ CF ＋ 5 - Fu） at a 21 - day cycle for at least 2 cycles. Gamma - knife treatment was conducted from the first day of the first chemotherapy cycle, with a total dosage of 40 -50 Gy （10 - 12 fractions） at 55% -85% equivalent dose curves. Results：All of the patients completed the treatment as planned and the acute side - effects presented as gastrointestinal reactions, myeloid suppression and peripheral nerve toxicity at 0 - Ⅱ degrees mostly. There was a low occurrence of acute radiation - induced esophagitis （ gradeⅠ°～Ⅱ°） and no occurrence of esophageal perforation, radiation - induced pulmonitis and trachitis. The overall response rate （ CR ＋ PR） was 91.7% （44/48）, the median survival time was 16. 2 months and the survival rates of 1, 2, 3 years were 70. 8%, 39. 6% and 31.3% respectively. Conclusion： Treatment of upper esophagus carcinoma patients with a combination of PCF chemotherapy and GKS - CRT has a mild side - effects and satisfactory short - term and long - term clinical effects, and the tolerance and compliance of patients are good.

关 键 词：高位食管癌 伽玛刀治疗 放射治疗 化疗 

分 类 号：R730.55[医药卫生—肿瘤]