同期适形放疗联合化疗治疗中晚期食管癌的临床研究  

Three dimensional conformal radiotherapy combined with chemotherapy for mediate and advanced stage esophageal cancer and analysis of prognostic factors

作　　者：张彬[1] 乔田奎[1] 高彩霞[1] 

机构地区：[1]复旦大学附属金山医院放疗科,上海200540

出　　处：《中国癌症杂志》2011年第10期803-806,共4页China Oncology

摘　　要：背景与目的:放化联合治疗是现今治疗中晚期食管癌的标准模式,本研究目的是观察三维适形放疗联合同期化疗治疗中晚期食管癌的不良反应与临床疗效。方法:32例符合入组条件的中晚期食管癌患者接受三维适形放疗及同期化疗。观察患者的治疗完成情况、治疗期间、治疗后的放化疗不良反应及临床疗效。同时进一步研究食管癌同期放化治疗所致放射性肺损伤的相关临床因素。结果:全组患者白细胞减少总发生率为90.62%;急性肝肾损伤总发生率为18.75%。急性放射性食管炎1级16例,2级12例,3级4例,无4级发生。急性放射性肺炎0级6例,1级22例,2级2例,3级2例,无4级发生。治疗结束后完全缓解(CR)8例,部分缓解(PR)21例,稳定(SD)3例,总有效率(PR+CR)为90.63%(29/32)。中位生存期16个月,1、2年生存率为73.5%和60.2%。单因素分析显示肿瘤GTV体积(P=0.000 6)和CT长度(P=0.06)是影响患者生存率的预后因素,肿瘤体积大小是唯一影响放射性肺炎严重程度(P=0.011)的预后因素。结论:LFP方案与放疗同步应用,不良反应较大,但可耐受,远期疗效有一定提高。Background and purpose：Three dimensional conformal radiotherapy（3D-CRT）combined with chemotherapy is the gold standard for mediate and advanced stage esophageal cancer.In this study,we evaluated the acute side effect and efficacy of three dimensional conformal radiotherapy combined with concurrent chemotherapy for mediate and advanced stage esophageal cancer.Methods：From Sep.2008 to Feb.2011,32 patients with mediate and advanced stage esophageal cancer were treated with 3D-CRT combined with concurrent chemotherapy of CF＋ 5-FU＋DDP（LFP）.The side effect and clinical result were observed.For further analysis the correlation coefficient affect pneumonities with spearman simultaneously.Results：The leucocytopenia rate was 90.62%,of 32 patients, 26 developed radiation pneumonitis（RP）：22 cases were grade 1,2 were grade 2 and 2 were grade 3,no radiation pneumonitis of grade 4.For the acute radiation esophagitis：none was grade 0,16 were grade 1,12 were grade 2 and 4 were grade 3.There were 8 patients（25%）received complete remission（CR）,21 patients（65.63%）received partial remission（PR）,the median survival time was 16 months the 1,2-year overall survival rates were 73.5%and 60.2%.The univariate analysis suggested that tumor volume（P=0.03）,length of CT（P=0.000 6）influenced survival of mediate and advanced stage esophageal cancer,the tumor volume before treatment（P=0.011）is the only factor influenced the order of severity of radiation pneumonitis.Conclusion：3D-CRT combined with concurrent chemotherapy of LFP could rise up 1,2-year survival rate,but the side effects were obviously.

关 键 词：食管癌 三维适形放射治疗 化学疗法 预后 

分 类 号：R735.1[医药卫生—肿瘤]