三维适形放射治疗对支架置入局部晚期食管癌的疗效观察  

Clinical analysis of combined esophageal stent inserting with three-dimensional conformal radiotherapy and concurrent chemotherapy on esophageal carcinoma

作　　者：叶宏勋[1] 高飞[1] 丁文秀[1] 

机构地区：[1]扬州大学第六临床医学院附属泰兴医院放疗科,江苏泰兴225400

出　　处：《现代肿瘤医学》2012年第11期2314-2316,共3页Journal of Modern Oncology

摘　　要：目的:观察同步放化疗治疗支架置入后中晚期食管癌的临床可行性及疗效。方法:回顾性分析44例局部晚期不能手术的食管癌患者。治疗组24例,先利用食管支架置入术解决中晚期食管癌患者的吞咽困难程度及病变部位的狭窄程度,然后针对原发病灶实施三维适形放射治疗,自首次放疗起同步静脉滴注氟尿嘧啶(5-FU)250 mg,第1天至第10天,顺铂(DDP)10 mg,第1天至第10天。观察组20例,不行放疗,食管支架置入术后与治疗组同期行相同方案化疗。结果:治疗组CR 3例(12.5%),PR 17例(70.8%),有效率(CR+PR)为83.3%,6个月、12个月近期生存率分别为87.5%、70.8%;观察组CR 1例(5.0%),PR 12例(60.0%),有效率(CR+PR)为65%,6个月、12个月近期生存率分别为55%、25%。两组比较差异有显著性(P<0.01)。治疗组的不良反应主要是血液学毒性和放射性食管炎发生率增加,但患者可耐受。结论:三维适形放疗与小剂量化疗同步,治疗支架置入后中晚期食管癌,可提高患者的近期有效率及生存率,可值得推广。Objective：To observe and evaluate the clinical feasibility and efficacy of combined esophageal stent insertion with radiotherapy and concurrent chemotherapy in the treatment of locally advanced esophageal carcinoma.Methods：All 44 patients with esophageal carcinoma who were not suitable for operation were analyzed retrospectively.In the therapy group,stent was placed in order to relieve esophageal stenosis,and then followed by 3D-CRT and concurrent chemotherapy,while patients in the observer group were treated with the placement of stent alone.Results：In the study group,70.8% of 24 cases was observed as partial response（PR）,and 12.5% with complete response（CR）,overall response rate was 83.3%.6 and 12 months survival rates were 87.5% and 70.8% in the study group,compared to 55%and 25% in the observer group,respectively（P〈0.05）.Conclusion：The result of 3D-CRT and concurrent chemotherapy plus stent placement was effective in the treatment of locally advanced esophageal carcinoma,it may improve the quality of life and survival time of the patients compared to that treated by stent placement alone.

关 键 词：食管癌 支架 三维适形放射治疗 小剂量化疗 

分 类 号：R735.1[医药卫生—肿瘤]