周剂量紫杉醇联合三维适形放疗治疗老年局部晚期食管癌40例疗效分析  

Three-dimensional conformal radiation therapy combined with concomitant weekly paclitaxel for the older adults with localized advanced esophageal carcinoma

作　　者：唐志[1] 王镇南[1] 李姝君[1] 陈满瑜[1] 陈华林[1] 杨志雄[1] 

机构地区：[1]广东医学院附属医院肿瘤中心,广东湛江524001

出　　处：《海南医学》2010年第12期64-67,共4页Hainan Medical Journal

摘　　要：目的探讨每周剂量紫杉醇联合三维适形放疗同步治疗老年局部晚期食管癌的临床疗效和安全性。方法将80例局部晚期老年食管癌患者随机分为两组,单纯放疗组(40例)采用单纯三维适形放疗,总剂量60-66Gy,6-7周完成;综合治疗组(40例)采用每周剂量紫杉醇联合三维适形放疗,紫杉醇用30mg/(m2.周),连续6-7周,放疗前给药。结果综合组和单放组的CR、PR、NR百分比分别为45%、47.5%、7.5%和22.5%、52.5%、25%。综合组和单放组的1、2、3年局部控制率分别为67.5%、52.5%、40%和52.5%、32.5%、22.5%。两组差异均有统计学意义(P<0.05)。综合组和单放组的1、2、3年生存率分别为57.5%、32.5%、22.5%和47.5%、27.5%、17.5%。两组差异无统计学意义(P>0.05)。综合组的放射性食管炎、白细胞减少发生率较单放组稍高,但可以耐受。结论每周剂量紫杉醇联合三维适形放疗同步治疗老年中晚期食管癌能提高近期疗效和局部控制率,副反应虽有所增大,但可耐受,不影响治疗的正常进行。Objective To evaluate the efficacy of three-dimensional conformal radiation combined with weekly paclitaxel for the older adults with localized advanced esophageal carcinoma.Methods 80 older adults with localized advanced esophageal carcinoma were divided into two groups： combined group （40 patients） and radiotherapy alone group （40 patients）. All patients were received 60-66Gy in 30-33 fractions using three-dimensional conformal radiation. Combined group were received chemotherapy with weekly Paclitaxel. Paclitaxel （30mg/m2） was administered once a week.Results The complete response rates （CR） and partial response （PR） rates of combined group and radiotherapy alone group were 45%, 47.5% and 22.5%, 52.5%, respectively （P0.05）. The local control rates at 1, 2, and 3 years were 67.5%, 52.5%, 40% and 52.5%, 32.5%, 22.5% in combined group and radiotherapy alone group, respectively （P0.05）. The 1-, 2-, 3-year surviva1 rates were 57.5%, 32.5%, 22.5% and 47.5%, 27.5%, 17.5% in combined group and radiotherapy alone group, respectively （P0.05）. The combined group had more obvious side-effect than the radiotherapy alone group. The major side effects were esophagitis and leucopenia, but were well tolerated.Conclusion Three-dimensional conformal radiation combined with weekly paclitaxel concomitant chemothrapy can significantly improve the short-term carcinoma and its side-effects do not interfere the treatment.

关 键 词：食管肿瘤/放射治疗 放射治疗 适形 化学疗法 紫杉醇 

分 类 号：R735.1[医药卫生—肿瘤]