后程加速超分割三维适形放疗联合卡培他滨治疗局部中晚期食管恶性肿瘤患者的疗效研究  

Study on effect of late course accelerated hyperfractionated three-dimensional conformal radiotherapy combined with capecitabine in the treatment of locally middle-late esophageal malignant tumor

作　　者：何兴平[1] 杨胜利[1] 代军[1] 彭明尧 高云[1] 周雪宇 

机构地区：[1]四川省攀枝花市中心医院肿瘤科,617067

出　　处：《临床合理用药杂志》2013年第32期13-15,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的探讨后程加速超分割三维适形放疗联合卡培他滨治疗局部中晚期食管恶性肿瘤患者的疗效和反应。方法 54例局部中晚期食管癌患者随机分为常规单放组26例和同步组28例,常规单放组仅接受放射治疗,采用6MV线照射总剂量(DT)68Gy;同步组采用6MV线照射,DT达40Gy时,予以重新CT定位并制定治疗计划,改为后程加速超分割放射治疗,加量DT 67Gy。同步组放疗加卡培他滨口服,至放疗结束。结果同步组和常规单放组1、2、3、4年生存率分别为82.0%、63.2%、52.4%、41.5%和52.8%、29.3%、18.9%、15.9%,2组间差异有统计学意义(P<0.05)。同步组放射性食管炎、放射性肺损伤、手足综合征等不良反应明显高于常规单放组,但2组患者骨髓抑制和胃肠道反应发生率比较差异无统计学意义(P>0.05)。结论后程加速超分割三维适形放疗联合卡培他滨对食管癌治疗有协同作用且不良反应小,是积极有效的措施之一,能提高局控率,减少复发率,从而延长生存时间,提高生存率。Objective To investigate the effectiveness and side effects of late course accelerated hyperfractionated three-dimensional conformal radiotherapy combined with eapeeitabine in the treatment of locally middle-late esophageal malig- nant tumor. Methods 54 cases of patients with locally middle-late esophageal malignant tumor were randomly divided into conventional radiotherapy group （26 cases） and concurrent group （28 cases）. The conventional radiotherapy group was given radiotherapy alone for treatment （ the total dose was DT68Gy by using 6MV radiation）. The concurrent group was treated by u- sing 6MV irradiation with DT40Gy,and they were given re- CT localization,and drawn up treatment plan,instead late course accelerated hyperfractionated three - dimensional conformal radiotherapy by increasing to DT67Gy. And the concurrent group was added with eapecitabine orally to the end of radiotherapy. Results The survival rate in 1,2,3 and 4 years of conventional radiotherapy groul~ and concurrent group was respectively 82.0% ,63.2% ,52.4% ,41.5% and 52. 8% ,29.3%, 18.9%, 15. 9% ,and the differences were statistically significant （P 〈 0.05 ）. The side effects as radiation esophagitis, radiation-in- ducad lung injury and hand - foot syndrome etc. in concurrent group was significantly higher than that of conventional radio- therapy group, but there was no significant difference between 2 group in aspect of incidence of myelosuppression and gastroin- testinal tract reaction （ P 〉 0.05）. Conclusions Late course accelerated hyperfractionated three-dimensional eonformal radio- therapy plus capocitabine has synergistic effects in the treatment of esophageal carcinoma,with little adverse reaction,is one of the positive effective measures, which can improve local control rate, reduce the recurrence rate, so prolong the survival time and improve survival rate.

关 键 词：食管恶性肿瘤 放射治疗 三维适形 化学治疗 卡培他滨 

分 类 号：R735.1[医药卫生—肿瘤]