局部晚期食管癌同步放疗化疗—TP3周与1周方案的疗效及经济成本探索  

Study of the efficacy,toxicity and economic cost of local advanced carcinoma of esophagus with concurrent chemoradiotherapy(to compare the TP scheme repeating for 3 weeks and 1 week)

作　　者：刘从斌[1] 

机构地区：[1]江苏省东海县人民医院放疗科,江苏东海222300

出　　处：《吉林医学》2013年第19期3792-3794,共3页Jilin Medical Journal

摘　　要：目的:比较紫杉醇加顺铂(TP 3周与1周)同步放疗化疗治疗局部晚期食管癌的疗效、不良反应及经济成本。方法:68例局部晚期食管癌患者,随机分成两组,每组34例,A组为TP 3周,B组为每周紫杉醇加顺铂同步放化疗组。两组均采用6MV或15MV X射线放射治疗,食管癌原发灶剂量60 Gy,区域淋巴结剂量预防剂量50Gy,阳性淋巴结组60Gy。A组为TP 3周,紫杉醇(TAX)0.1,第1天,第8天;DDP 30 mg/第1～4天。B组放疗同时给予紫杉醇60mg+DDP 30 mg,第1天、第8天、第15天、第22天、第29天、第36天静脉滴注。结果:A组和B组的1、3年局部无进展生存率(CR+PR)分别为72.6%、51.2%与71.9%、49.3%,两组比较差异无统计学意义(P>0.8及P>0.7)。A组和B组的Ⅲ、Ⅳ血液及消化道不良反应分别为8.9%、11.8%,差异无统计学意义(P>0.9);A组和B组的经济成本平均分别为A组:C药7 004元、C检2 563元,B组:C药8 558元、C检2 887元,差异有统计学意义(P<0.01)。结论:A组和B组的1、3年无进展生存率相似,不良反应相似,经济成本有较大差别。Objective To compare the efficacy,toxicity and economic cost of concurrent chemoradiotherapy with paclitaxel and cisplatin weekly and 3 weeks repeated on locally advanced esophageal carcinoma.Method The sixty-eight local advanced esophagus patients were randomly divided into two groups,A group was done TP scheme with interval 3-week repeated which paclitaxel was drop with 0.2 d1,d8,cisplatin was drop with 30mg d1-4 and concurrent radiotherapy,B group was done TP scheme 1 week which paclitaxel was drop with 60mg,cisplatin was drop with 30mg and concurrent radiotherapy.The 68 patients were irradiated with 6M or 15M x-ray,The gross tumor volume of esophagus carcinoma was irradiated by dose of 60Gy,the negative lymphatic regional was irradiated by preventing dose of 50Gy,the positive lymphatic nodes were irradiated by dose of 60 Gy.Results The group A and group B which local free progression-survival（CR＋PR） of 1 year and 3 years were 72.6% and 51.2% VS 71.9% and 49.3% respectively,there was no significant difference（P0.8 and P0.7）between A and B group.The group A and group B which Ⅲ、Ⅳgrade toxicity of marrow and alimentary system were 8.9% and 11.8%,there was no significant difference（P0.9）between A and B group respectively.The economic cost of A group was 9567（medicine meaning cost was 7004,examining meaning cost was 2563）,The economic cost of B group was 11445（medicine meaning cost was 8558,examining meaning cost was 2887）,there were significant differences（P0.01）.Conclusion The 1 year and 3 years local progression-free survival of group A and group B were resemble,the toxicities were resemble,the economic meaning cost of the A and B were more difference.

关 键 词：食管癌 紫杉醇 顺铂 同步放化疗 疗效 不良反应 平均经济成本 

分 类 号：R735.1[医药卫生—肿瘤]