三维适形放疗联合化疗治疗食管癌上纵隔淋巴结转移的疗效分析  

Three dimensional conformal radiotherapy combined with chemotherapy for patients with upper mediastinal lymph nodes metastases from esophageal carcinoma

作　　者：毕良文[1] 张丽珍[1] 赵滑峰[1] 赵维勇[1] 田继红[1] 唐鹿群[1] 

机构地区：[1]南京医科大学第二附属医院放疗科,江苏南京210011

出　　处：《中华肿瘤防治杂志》2009年第20期1597-1598,1602,共3页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:探讨三维适形放疗联合化疗治疗食管癌上纵隔淋巴结转移的近期疗效。方法:回顾性分析15例食管癌上纵隔淋巴结转移患者。转移灶直径<3cm4例,3～5cm8例,>5cm3例,15例中右上纵隔13例,左上纵隔2例。三维适形放疗采用常规分割,1.8～2Gy/次,5次/周,总剂量50～64Gy(既往做过放疗的给予50Gy),5～7周完成。全身化疗采用顺铂(DDP)30mg/m2,d1～d3;亚叶酸钙(LV)500mg/m2,d1～d5;5-氟尿嘧啶(5-FU)500mg/m2,d1～d5,均静脉滴入,21d为1个周期,放疗前化疗1个周期,共4～6个周期。结果:治疗后1个月复查,病灶达CR者9例,病灶达PR者4例,无进展病例。6个月、1年生存率分别为100%、86.7%。结论:食管癌上纵隔淋巴结转移进行三维适形放射治疗联合PF方案化疗,此方案患者可耐受,方法可行。OBJECTIVE：To evaluate the short-term curative effect of 3-dimensional conformal radiotherapy（3D-CRT）combined with chemotherapy on upper mediastinal lymph nodes metastases from esophageal carcinoma.METHODS：Fifteen esophageal carcinoma patients with upper mediastinal lymph nodes metastases were treated by 3D-CRT combined with chemotherapy.In 4 patients,the lymph node diameter was less than 3 cm.The lymph node diameter was between 3 to 5 cm in 8 patients,and was greater than 5 cm in 3 patients.The numbers of the patients with lymph nodes at the upper right and upper left were 13 and 2 respectively.The patients received 3D-CRT were given the dose of 50-64 Gy（1.8-2 Gy/f,5 f/w,5-7 w）,and 4-6 times chemotherapy.The patients who had been given radiotherapy was irradiated 50 Gy.Chemotherapy regimen：intravenous drip of cisplatin 30 mg/m2,d1-d3,leucovorin 500 mg/m2 and 5-fluorouracil 500 mg/m2,d1-d5.Twenty-one days as one cycle,and the chemotherapy was carried out before radiotherapy for one cycle,with 4-6 cycles totally.RESULTS：In the 15 patients,9 patients showed complete response and 4 patients showed partial response one month after the treatment,with no progression of disease.The survival fraction in 6 months and 1 year were 100% and 86.7% respectively.CONCLUSION：Three-dimensional conformal radiotherapy combined with chemotherapy for patients with upper mediastinal lymph nodes metastases from esophageal carcinoma is feasible and effective and with tolerable side effects.

关 键 词：食管肿瘤/放射疗法 三维适形放疗 转移 回顾性研究 

分 类 号：R735.1[医药卫生—肿瘤]