GP与PF方案联合同步放疗治疗食管癌近期疗效比较  

Clinical comparison of short term effects of regimen GP and PF combined with synchronous radiotherapy in treating esophageal carcinoma

作　　者：刘学芬[1] 张力[1] 彭东[1] 任必勇[1] 张军[1] 冉文华[1] 

机构地区：[1]重庆三峡中心医院肿瘤科,重庆万州404000

出　　处：《重庆医学》2012年第27期2822-2823,2826,共3页Chongqing medicine

摘　　要：目的观察GP与PF方案联合同步放疗治疗食管癌近期疗效与不良反应。方法对经病理明确诊断为食管鳞癌的患者72例,采用随机法分为观察组(GP方案联合同步放疗)和对照组(PF方案联合同步放疗)。对照组:顺铂(DDP)25mg/m2,第1～3天,5-氟尿嘧啶(5-Fu)500mg/m2,第1～5天;28d为1个周期,连续2个周期;同步三维适形放疗从化疗第1天开始:总剂量(DT)54～64Gy,每天1次,每次2Gy,每周5d,连用6～7周。观察组:吉西他滨0.8～1.0g/m2,第1、8天;DDP 25mg/m2,第1～3天,28d为1个周期,连续2个周期;同步三维适形放疗方案同对照组。结果对照组完全缓解(CR)10例(27.8%),部分缓解(PR)13例(36.1%),稳定(SD)8例(22.2%),进展(PD)5例(13.9%),总有效率(CR+PR)63.9%;观察组CR 13例(36.1%),PR 18例(50.0%),SD 3例(8.3%),PD 2例(5.6%),总有效率86.1%;两组总有效率比较差异有统计学意义(P<0.05)。两组不良反应的差异无统计学意义(P>0.05)。结论 GP方案联合同步放疗治疗食管癌近期效果良好,且不增加局部不良反应,值得临床推广。Objective To investigate the effects and adverse reactions of gemcitabine plus cisplatin（GP） combined cisplatin plus 5-fluorouracil（PF） with synchronous radiotherapy in the treatment of esophageal carcinoma. Methods 72 cases with pathologically diagnosed esophageal squamous cell carcinoma were randomized into 2 groups. The control group（36 cases） was treated with cispla- tin（25 mg/m^2 , on 1-3 d） and 5-fluorouracil（500 mg/m^2 , on 1-5 d） with 28 d as a cycle, for continuous 2 cycles. The synchronous three dimensional conformal radiation therapy（6MV - X ray, 2Gy per fraction, 5 d per week, continuous 6 - 7 weeks, total dose 54 - 64 Gy） were performed on the first day of chemotherapy. The study group（36 cases） was treated with gemcitabine（0.8- 1.0 g/ m^2 ,on 1,8 d） and cisplatin（25 mg/m^2 ,on 1-3 d） with 28 d as a cycle,for continuous 2 cycles. The scheme of synchronous three dimensional conformal radiation therapy was identical with the control groups. Results In the control group,10 cases achieved corn plete remission（CR） and 13 cases achieved partial remission（PR）, the overall response rate（CR＋ PR） was 63. 9 %. In the study group, 13 cases achieved CR and 18 cases achieved PR,the overall response rate was 86.1 %. There was statistical difference in the overall response rate between the two groups（P〈0.05）. The adverse reactions had no statistical difference between the two groups （P〈0.05）. Conclusion The effects of GP regimen combined with synchronous radiotherapy in the treatment of esophageal carcinoma are good without increasing local adverse reactions, which deserves to popularize in clinic.

关 键 词：化学疗法 放射疗法 食管肿瘤 氟尿嘧啶 顺铂 

分 类 号：R735.1[医药卫生—肿瘤]