替加氟加顺铂联合三维适形放疗治疗非手术食管癌临床观察  

Clinical observation of tegafur pins cisplatin combined with three-dimensional conformal radiotherapy in the treatment of non-operation esophageal carcinoma

作　　者：林丹霞[1] 陈世坚[2] 陈晨[3] 丘希辉[1] 方玫玫[1] 

机构地区：[1]汕头大学医学院附属肿瘤医院中西医结合科,515031 [2]汕头大学医学院附属肿瘤医院放疗科,515031 [3]汕头大学医学院附属肿瘤医院药剂科,515031

出　　处：《肿瘤研究与临床》2014年第3期163-165,共3页Cancer Research and Clinic

摘　　要：目的 评价替加氟加顺铂联合三维适形放疗治疗非手术食管癌患者的客观疗效、不良反应及生存情况.方法 将符合入选条件的184例非手术食管癌患者分为两组：顺铂（DDP）加替加氟方案（PT方案）组和DDP加5-氟尿嘧啶（5-Fu）方案（PF方案）组,化疗在放疗第1、29天进行,共2个周期.两组均采用三维适形放疗,（50～70）Gy/ （5～7）周的常规放疗.两组放化疗结束后,各组均有14例再原方案化疗1个疗程,28例再原方案化疗2个疗程,50例无化疗.结果 PT组近期有效率为69.57％（64/92）,PF组67.39％（62/92）,两组差异无统计学意义（x2=0.l01,P=0.874）.放射性食管炎和白细胞下降是影响治疗的主要不良反应,PT组明显低于PF组,差异具有统计学意义（P＜0.05）.1、2、3年的生存率PT组分别为74.9％、61.6％和52.8％,PF组分别为75.8％、56.9％和48.0％,两组差异有统计学意义（x2=7.325,P=0.007）.结论 DDP联合替加氟或5-Fu的化疗方案同期联合三维适形放疗均是治疗非手术食管癌的有效方法,但DDP联合替加氟组的不良反应明显低于DDP联合5-Fu组,患者的生活质量明显提高.Objective To evaluate the therapeutic effetive, toxicity and survial rate of non-operation esophageal carcinoma patients treated by tegafur plus cisplatin combined with three-dimensional conformal radiotherapy （3D-CRT）. Methods 184 cases of non-operation patients with esophageal carcinoma were divided into two groups. The cases of treatment group were treated by cisplatin and tegafur. The cases of control group were treated by cisplatin and 5-Fu. All patients received 3D-CRT, and the total radiation dose was 50-70 Gy. Each group had 14 cases treated with primary chemotherapy for 1 course, 28 cases for 2 courses, and 50 cases without any chemotherapy. Results The recent effect rate was 69.57 % （64/92） in treatment group and 67.39 % （62/92） in control group, there was no statistical difference （X2 = 0.101, P = 0.874）. Radioactive esophagitis and leukopenia were the main side effect of treatment. The treatment group was significantly lower than that of the control group, the difference had statistical significance. The 1-, 2- and 3-year survival rates were 74.9 %, 61.6 %, 52.8 %, respectively in treatment group and 75.8 %, 56.9 %, 48.0 %, respectively in control group. The control group survival rates were significantly higher than the treatment group, the difference had statistical significance （X2= 7.325, P = 0.007）. Conclusions Cisplatin plus tegafur or 5-Fu combined with 3D-CRT is effective way of treatment for non-operation of esophageal carcinoma. The toxicity of cisplatin plus tegafur group is significantly lower than cisplatin plus 5-Fu group, therefor it can improve the quality of life of the patients obviously.

关 键 词：食管肿瘤 三维适形放疗 药物疗法 同步放化疗 疗效观察 

分 类 号：R735.1[医药卫生—肿瘤]