奈达铂联合调强放疗治疗食管癌术后纵隔淋巴结转移的临床观察  

Study of nedaplatin with concurrent intensity-modulated radiation therapy(IMRT) for post-operative mediastinal lymph node metastases in patients with esophagus squamous carcinoma

作　　者：罗波[1] 郭友全[1] 曾凡玉[1] 黎艳萍[1] 罗燕[1] 

机构地区：[1]湖北省肿瘤医院放疗科,湖北武汉430079

出　　处：《现代肿瘤医学》2013年第7期1500-1502,共3页Journal of Modern Oncology

摘　　要：目的:观察小剂量奈达铂单药联合调强放疗,治疗食管鳞癌术后纵隔淋巴结转移的近期和远期疗效及毒副反应。方法:67例食管癌术后纵隔淋巴结转移患者随机分为两组,单纯调强放射治疗组(RT)32例,调强放射治疗联合奈达铂单药增敏组(Concurrent RT)35例。RT组仅接受调强放射治疗,Concurrent RT组患者接受调强放射治疗和同步小剂量奈达铂单药化疗。两组放疗剂量60-70Gy,2.0Gy/fraction,5/week,奈达铂单药化疗采用每周奈达铂30mg/m2,静脉滴注,连续6周。化疗过程中注意观察不良反应,每周方案分别评价两组的疗效和毒副反应。结果:RT组:CR 8例,PR 11例,SD 12例,PD 1例,有效率为59.4%(19/32);Concurrent RT组:CR 1 2例,PR 1 7例,SD 4例,PD 2例,有效率为82.9%(29/35),比较有显著差异(P<0.05)。RT组和Concurrent RT组中位生存期分别为9和13个月,比较无差异(P>0.05)。常见的不良反应主要为血液毒性、放射性肺炎、放射性食管炎等,两组比较无显著性差异。两组均无明显胃肠道反应。结论:与单纯调强放射治疗相比,食管癌术后仅纵隔淋巴结转移而无远处转移的患者采取小剂量奈达铂增敏联合调强放疗,能够显著提高治疗的有效率并且未明显增加毒副反应。但奈达铂单药增敏未能提高患者生存期。Objective：To evaluate the efficacy and toxicity of low dose nedaplatin chemotherapy with concurrent intensity-modulated radiation therapy（IMRT） for post-operative mediastinal lymph node metastases in patients with esophagus squamous carcinoma.Methods：A total of 67 patients of esophagus squamous carcinoma with post-operative mediastinal lymph node metastases were divided into the irradiation group（32 cases） and the concurrent group（35 cases）.Both groups received IMRT radiotherapy with a total dose of 66-70Gy,2.0Gy/fraction,5 times per week.The patients in concurrent group were treated with nedaplatin（30mg/m2） weekly for 6 weeks.Results：The response rates of the irradiation group and the concurrent group were 59.4%（19/32） and 82.9%（29/35）,respectively with a statistical significance（P0.01）.Median survival time was 9 months in the irradiation group and 13 months in the concurrent group.Common side effects in both groups were hematologic toxicity,radiation induced pulmonary injury,and radiation esophagitis.Incidences of these side effects between two group showed no significant difference.And no obvious gastrointestinal toxicities were observed.Conclusion：In patients with esophagus squamous carcinoma,compared with IMRT alone.IMRT combined with concurrent nedaplatin chemotherapy have better efficacy for post-operative mediastinal lymph node metastases without increasing toxicity.However,concurrent nedaplatin chemotherapy does not improve survival of these patients.

关 键 词：奈达铂 化学治疗 同步放射治疗 食管癌 调强放射治疗 

分 类 号：R735.1[医药卫生—肿瘤]