三维适形放疗同步FOLFOX4化疗治疗术后腹膜后恶性淋巴结转移癌的疗效观察  

Efficacy of three dimensional conformal radiotherapy combined with FOLFOX4 chemotherapy synchronously in treatment of postoperative malignant retroperitoneal lymph node metastasis carcinoma

作　　者：卢庆刚[1] 牟安娜[1] 朱礼[1] 

机构地区：[1]辽宁省肿瘤医院放疗一科,沈阳110042

出　　处：《疑难病杂志》2014年第3期284-286,290,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的观察三维适形放疗(3DCRT)同步FOLFOX4方案治疗术后腹膜后恶性淋巴结转移癌的临床疗效。方法消化道恶性肿瘤手术切除后发生腹膜后淋巴结转移癌患者85例,随机分为同步放化疗组(45例)与单纯化疗组(40例),单纯化疗组采用FOLFOX4化疗方案,同步放化疗组采用三维适形放疗同步FOLFOX4方案,对比治疗结束后近期(3个月)疗效、治疗期间不良反应及远期(3年)生存率。结果(1)近期疗效:同步放化疗组肿瘤控制率为82.2%、KPS评分为(83.0±5.9)分,均显著高于单纯化疗组的62.5%和(80.4±5.2)分(P<0.05)。(2)不良反应:放射性皮炎、放射性肺(气管)炎为同步放化疗组特异性不良反应,发生率与单纯化疗组比较差异有统计学意义(P<0.05)。其他不良反应差异无统计学意义(P>0.05)。(3)同步放化疗组累积生存率(0.258±0.013)、平均生存期(26.867±0.214)月均显著高于单纯化疗组的(0.137±0.012)月和(21.550±0.251)月,差异有统计学意义(P均<0.05)。结论三维适形放疗同步FOLFOX4化疗治疗术后腹膜后恶性淋巴结转移癌可提高患者生存率、延长生存期,具有较高的近远期疗效。Objective To observe the clinical efficacy of three-dimensional conformal radiotherapy （3DCRT） syn-chronized with FOLFOX4 in treatment of postoperative peritoneal malignant cancer of lymph node metastasis .Methods 85 patients with retroperitoneal lymph node metastases after resection of gastrointestinal cancer surgery were randomly divided into concurrent chemoradiotherapy group （45 cases） and the chemotherapy alone group （40 cases）, chemotherapy group used of FOLFOX4, concurrent chemoradiotherapy group using three -dimensional conformal radiotherapy with FOLFOX 4, the recent long-term efficacy and adverse reactions during treatment （3 months） and after the end of treatment （3 years） survival rate were compared.Results （1） Short-term effect： concurrent chemoradiotherapy group tumor control rate was 82.2%, KPS score was （83.0 ＆#177;5.9） points, which were significantly higher than the 62.5% in the chemotherapy group with （80.4 ＆#177; 5.2） points （ P ＆lt;0.05）.（2） Adverse reactions： radiation dermatitis, radiation-induced lung （trachea） inflammation were concurrent chemoradiotherapy group specific adverse reaction , incidence difference between the two group was statistically sig -nificant.Other adverse reactions were found no significant difference （ P ＆gt;0.05）.（3） The cumulative survival rate （0.258 ＆#177;0.013）, mean survival months （26.867 ＆#177;0.214） in chemoradiotherapy group were significantly higher than in the chemo -therapy group （0.137 ＆#177;0.012）, （21.550 ＆#177;0.251） （ P ＆lt;0.05）.Conclusion Three-dimensional conformal radiotherapy with FOLFOX4 in treatment of postoperative chemotherapy retroperitoneal lymph node metastases of malignant cancer may im -prove survival, prolong survival, with a high near-term effect.

关 键 词：放疗 三维适形 FOLFOX4 肿瘤 消化道 转移癌 淋巴结 生存率 FOLFOX4 

分 类 号：R735.4[医药卫生—肿瘤]