热放化疗治疗食管癌和贲门癌腹膜后淋巴结转移  

Regional thermotherapy combined with radiotherapy and chemotherapy for treatment of retroperitoneal lymph node metastasis of esophageal and gastric cardiac carcinoma

作　　者：赵军[1] 张丽华[1] 孙桂明[1] 王彦文[1] 盛延兴[1] 

机构地区：[1]聊城市人民医院肿瘤科,聊城252000

出　　处：《中国肿瘤临床与康复》2010年第1期33-35,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨三维适性放疗与区域性热疗及卡培他滨同步治疗食管癌及贲门癌腹膜后淋巴结转移的近期疗效及安全性。方法67例患者随机分为两组,治疗组采用三维适性放疗(3D-CRT)及服用卡培他滨配合区域性热疗治疗。3D-CRT分割剂量2～3Gy/次,5次/周,总剂量45～60Gy/15～30次,3～6周。卡培他滨2500mg/(m2·d),分两次口服,连用14d。区域性热疗每周2次,直至治疗结束。对照组放化疗方法同治疗组。同时检测两组治疗前后T细胞亚群变化。结果治疗组总有效率(CR+PR)为73.7%,症状缓解率为88.2%;对照组总有效率为51.7%,症状缓解率为64.0%,两组比较差异具有显著性。治疗后治疗组T细胞亚群中CD3+、CD4+、CD4+/CD8+均有一定程度升高,与对照组相比差异有显著性(P<0.05)。两组Ⅱ～Ⅲ级骨髓抑制比较差异无显著性。结论热放化疗同步治疗食管癌及贲门癌腹膜后淋巴结转移为一种安全有效的治疗手段。Objective To investigate the efficacy and side-effect of regional thermotherapy plus conformal radiotherapy and capecitabine in treatment of retroperitoneal lymph node metastasis of esophageal and gastric cardiac carcinoma.Methods Sixty-seven patients were divided into two groups randomly.The treatment group was treated with regional thermotherapy plus conformal radiotherapy and capecitabine.The total dose of radiotherapy was 45-60 Gy in 3-6 weeks,2-3 Gy/day,five times /week,and capecitabine was taken for fourteen days,2500 mg/m^2 /day.In the meantime,regional thermotherapy was given twice per week.Control group only received identical radiotherapy and chemotherapy.Results In treatment group,the overall response rate（CR ＋ PR） was 73.7%,and remission rate of symptoms was 88.2% ;while in control group,the overall response rate（CR ＋ PR） was 51.7%,and remission rate of symptoms was 64.0%.The overall response rate and remission rate of symptoms in treatment group were much higher than those of control group,and significant difference between the two groups was found（P 〈 0.05）.In treatment group,T-lymphocyte subsets CD3 ＋,CD4 ＋ and CD4 ＋ /CD8 ＋ were increased to some extent,and there was significant difference compared with the control group.No significant difference in class Ⅱ-Ⅲ myelosuppression was found between the two groups.Conclusion Radiotherapy and chemotherapy combined with thermotherapy is effective and safe for treatment of retroperitoneal lymph node metastasis of esophageal and gastric cardiac carcinoma.

关 键 词：食管肿瘤 贲门肿瘤 腹膜后肿瘤 适形放疗 区域性热疗 

分 类 号：R735[医药卫生—肿瘤]