榄香烯乳联合顺铂同步放化疗后PF巩固化疗治疗中晚期食管癌  

Effect of the combination of Elemene and concurrent chemoradiation with cisplatin followed by consolidation chemotherapy with cisplatin and fluorouracil for locally advanced esophageal cancer

作　　者：顾本兴[1,2] 胡建斌[1,2] 刘海[1,2] 孙晓南[1,2] 朱艳虹[1,2] 

机构地区：[1]浙江大学医学院附属邵逸夫医院肿瘤放疗科 [2]浙江大学邵逸夫临床医学研究所,杭州市310016

出　　处：《中国肿瘤临床》2013年第10期600-603,共4页Chinese Journal of Clinical Oncology

基　　金：浙江省中医药科技计划(编号:2010ZB079)资助~~

摘　　要：目的:探讨榄香烯乳联合顺铂同步放化疗后顺铂+5-Fu(PF)巩固化疗治疗中晚期食管癌的临床疗效。方法:榄香烯联合顺铂同步放化疗后PF巩固化疗治疗64例中晚期食管癌:放疗采用三维适形放疗,常规分割,靶区总剂量55.8～66.6 Gy;放疗同时给予顺铂(30 mg/m2第1～3天,21天为一周期)化疗2周期。同步放化疗结束后给予不多于4周期PF方案(顺铂30 mg/m2第1～3天,5-Fu500 mg/m2第1～5天)巩固化疗。其中联合组34例放疗期间应用榄香烯乳500 mg,每日1次,每周5次,巩固化疗期间第1～5天给予榄香烯乳500 mg,与同期接受顺铂同步放化疗后PF巩固化疗的30例中晚期食管癌患者进行对照。结果:1)对照组和联合组有效率分别为63.3%和85.2%,差异有统计学意义(P<0.05)。2)对照组1、2年局部控制率分别为56.7%和33.8%,联合组分别为69.9%和44.7%,联合组有改善局部控制率的趋势(P=0.133);对照组1、2年生存率分别为60.0%和34.6%,中位生存时间为13个月,联合组1、2年生存率分别为64.7%和42.6%,中位生存时间为15个月,Log-rank检验差异无统计学意义(P>0.05)。3)对照组Ⅲ、Ⅳ级白细胞下降的发生率为30%,明显高于联合组的8.8%(P<0.05),Ⅲ、Ⅳ级血小板下降、胃肠道反应、放射性食管炎、放射性气管炎等急性不良反应两组差异有无统计学意义(P<0.05)。结论:顺铂同步放化疗后PF巩固化疗治疗中晚期食管癌具有一定的疗效。榄香烯乳联合放化疗有助于提高近期疗效,减轻血液学毒性,值得进一步研究。Objective： The present study aimed to investigate the effect of the combination of Elemene and concurrent chemora- diation with cisplatin followed by consolidation chemotherapy with cisplatin and fluorouracil （PF） for locally advanced esophageal can- cer. Methods： Sixty-four patients with locally advanced esophageal cancer were treated by using concurrent chemoradiation with cispla- tin followed by PF consolidation chemotherapy. Concurrent chemoradiation consisted of three-dimensional conformal radiation at a to- tal dose of 55.8 Gy to 66.6 Gy and two 21-d cycles of concurrent chemotherapy with 30 mg/㎡ cisplatin from days 1 to 3. Concurrent chemoradiation was followed by no more than four cycles of consolidation chemotherapy with 30 mg/㎡ cisplatin from days 1 to 3 and 500 mg/㎡ fluorouracil from days 1 to 5. For 34 cases in the union group, 500 mg/d Elemene was given during radiation and consolida- tion chemotherapy. Results： The overall response rates of the control group and the union group were 63.3% and 85.2% （P〈0.05）, re- spectively. The one- and two-year local control rates of the control group were 56.7% and 33.8%, respectively, whereas those of the union group were 69.9% and 44.7%, respectively. The union group showed an increasing improvement trend on the one- and two-year local control rates （P-0.133）. The one- and two-year overall survival rates in the control group were 60.0% and 34.6%, respectively, with median survival time of 13 months, whereas those in the study group were 64.7% and 42.6%, respectively, with median survival time of 15 months （P〉0.05）. The incidence of grade 3 or grade 4 leukocytopenia in the control group was significantly higher than that in the union group （30% versus 8.8%, P〈0.05）. Incidences of thrombocytopenia, gastrointestinal reaction, acute radiation esophagitis, and radiation bronchitis were similar in both groups. Conclusion： Concurrent chemoradiation with cisplatin followed by consolidation chemotherapy with PF regimen is effective

关 键 词：榄香烯乳 食管癌 三维适形放疗 化疗 

分 类 号：R735.1[医药卫生—肿瘤]