三维适形放疗同步应用铂金属和紫杉醇对食管癌的临床疗效  

Clinical Effect of Paclitaxel and Platinum Metals Combined with 3D-Radiotherapy for Esophageal Cancer Therapy

作　　者：周江云[1] 尤圣勇 彭康明[1] 

机构地区：[1]如皋市人民医院肿瘤科,226500

出　　处：《实用癌症杂志》2012年第5期486-488,491,共4页The Practical Journal of Cancer

摘　　要：目的比较奈达铂和紫杉醇同步放疗、奈达铂同步放疗和顺铂同步放疗治疗食管癌的疗效和不良反应。方法将92例食管癌患者随机分为奈达铂和紫杉醇同步放疗组(A组)、奈达铂同步放疗组(B组)和顺铂同步放疗组(C组)。均采用加速器6MV的X线三维适形放疗,总剂量60～70 Gy。A组放疗同时每3周应用紫杉醇135 mg/m2(d1)和奈达铂25 mg/m2(d1～3)化疗,至放疗结束;B组放疗同时每3周应用奈达铂30 mg/m2(d1～3)化疗,至放疗结束;C组放疗同时每3周应用顺铂30 mg/m2(d1～3)化疗,至放疗结束。结果奈达铂和紫杉醇同步放疗能有效提高近期疗效和远期疗效,但不良反应较重。奈达铂同步放疗方案与顺铂同步放疗方案比较,近期疗效和2年生存率有所提高,胃肠道反应也轻,但骨髓抑制反应较严重。结论奈达铂和紫杉醇同步放疗对中晚期食管癌的疗效较好,不良反应可耐受。Objective To evaluate the efficacy and toxicities of concurrent 3D-radiotherapy combined with paclitaxel plus nedaplatin,nedaplatin or cisplatin in the treatment of patients with esophageal cancer.Methods 92 patients with esophageal cancer were randomly divided into three groups.Patients in group A were treated with concurrent paclitaxel of 135 mg/m2 in day1 plus nedaplatin of 25 mg/m2 from day1 to day3;patients in group B were treated with concurrent nedaplatin of 30 mg/m2,from day1 to day3,and patients in group C were treated with concurrent cisplatin of 30 mg/m2 from day1 to day3.The concurrent chemotherapy was repeated every 3 weeks,and the radiotherapy techniques and dose were the same in the three groups.Results Concurrent chemoradiotherapy with paclitaxel plus nedaplatin significantly improved the short and long-term tumor control,but with more severe toxicities.Concurrent nedaplatin and radiotherapy had better short-term and 2 year clinical effect and less gastrointestinal toxicities,but the bone marrow side effects were more severe than concurrent cisplatin and radiotherapy.Conclusion Concurrent chemoradiotherapy with nedplatin plus paclitaxel is effective and tolerable in the treatment of patients with esophageal cancer.

关 键 词：食管癌 三维适形放疗 紫杉醇 奈达铂 

分 类 号：R735.1[医药卫生—肿瘤]