奈达铂联合替加氟同步放疗在局部进展食管癌应用及临床价值  

The application of nedaplatin plus ftorafur combined with radiotherapy in treating local advanced esophageal cancer and it's clinical value

作　　者：何斌[1] 殷红梅[1] 崔珍[1] 楼建军[1] 江浩[1] 沈学明[1] 

机构地区：[1]蚌埠医学院第一附属医院肿瘤放疗科,安徽233004

出　　处：《齐齐哈尔医学院学报》2014年第11期1578-1580,共3页Journal of Qiqihar Medical University

基　　金：安徽省十二五临床医学重点专科建设基金(01Z33)

摘　　要：目的 探讨奈达铂＋替加氟同步放疗治疗局部晚期食管癌的临床疗效及价值.方法 2009年6月至2011年12月间66例经病理检查证实的局部晚期食管癌患者,随机分为同步放化疗组34例及单纯放疗组32例,两组均采用三维适形调强放射治疗,1.8～ 2.0 Gy/次,5次/周,放疗剂量60～66 Gy.同步化疗方案为奈达铂（NDP）80 ～ 100 mg/m2,d1,替加氟1 000 mg/d,d1 ～5,静脉滴注,28 d重复一次,同步化疗两周期.结果 同步放化疗组完全缓解8例,部分缓解21例,有效率为85.2％（29/34）;单纯放疗组完全缓解5例,部分缓解20例,有效率为78.1％（25/32）,χ^2=0.570,P=0.450.两组1年生存率分别为70.6％（24/34）、62.5％（20/32）,χ^2=0.533,P=0.465,两年生存率为44.1％（15/34）、37.5％（12/32）,χ^2=0.299,P=0.585,差异无显著统计学意义.同步放化疗组2～3度白细胞下降52.9％（18/34）,单纯放疗组为25.0％（8/32）,χ^2=5.39,P=0.020;2度血小板下降同步放化疗组2例,单纯放疗组无3度血小板下降.结论 奈达铂联合替加氟同步调强放疗可提高局部进展食管癌近期疗效,治疗毒副作用可以耐受,远期疗效尚待进一步观察.Objective To analyze the clinical efficacy and value of nedaplatin plus fiorafur combined with radiotherapy in treating local advanced esophageal cancer. Methods A total of 66 patients suffered from local advanced cancer, which were proved by pathology during Jun 2009 and Dec 2011, were randomly divided into radiotherapy group （ n = 34 ） and combination group （ n = 32 ）. All the patients received intensity modulated radiation therapy with a total dose of 60 - 66Gy, 1.8 - 2.0Gy a fraction and 5 fractions per week. Concurrent chemotherapy program was nedaplatin plus ftorafur （nedaplatin 80 - 100mg/m2/d1 and fiorafur 1000mg/d1 -5, intravenous infusion ）, lasted for 2 cycles. Results 8 patients got completely remission and 21 got partial remission in concurrent chemotherapy group, the effective rate was 85.2% （29/34）. 5 patients achieved complete remission and 20 patients had partial remission in radiotherapy group, effective rate was 78.1% （25/ 32 ）. The differences of effective rate between the two groups were not statistically significant （ χ^2 = 0. 570, P = 0. 450）. The survival rates at 1 - year were 70.6% （24/34） and 62.5% （20/32） respectively,two - year survival rates were 44.1% （15/34） and 37.5% （12/32）, the results showed no statistical difference between the two groups （ χ^2 = 0. 533, p = 0. 465 ;χ^2 = 0. 299, P = 0. 585 ）. The occurrence rate of grade 2/3 leukopenia in concurrent chemotherapy group （ 52.9% , 18/34） was higher than that was in radiotherapy group （25.0% , 8/32 ; χ^2 =5.39,P =0. 020）. 2 patients of concurrent chemotherapy group appeared grade 2 thrombopenia, and one in radiotherapy group. Conclusions The application of intensity modulated radiation therapy combined with nedaplatin plus florafur could improve the short - term efficacy of treating local advanced esophageal cancer, and the side toxicity was acceptable, but the long - term follow - up result need further observation.

关 键 词：食管肿瘤 放射治疗 奈达铂 调强放疗 

分 类 号：R735.1[医药卫生—肿瘤]