食管胃结合部癌治疗中替吉奥胶囊同步三维适形放疗的临床应用  

Clinical observation in three dimensional conformal radiotherapy combined with synchronous chemotherapy of Tijiao capsule for advanced adenocarcinoma

作　　者：高彤[1] 王晓燕[1] 赵丽霞[1] 张继红[1] 冯景见[1] 檀军丽[1] 郭燕[1] 吴小良[1] 

机构地区：[1]石家庄市第一医院肿瘤五科,050011

出　　处：《疑难病杂志》2014年第7期690-693,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的探讨替吉奥同步放化疗治疗中晚期食管胃结合部癌的疗效及不良反应。方法 48例中晚期食管胃结合部癌患者,随机分成2组:同步组25例和单放组23例。2组均采用6MV-X射线三维适形放射治疗.总剂量6 000 cGy/6周。同步组放疗第1天同时口服替吉奥胶囊,早晚各1次,14 d为1个周期,停药7 d后进行下1个周期。结果同步组剔除1例。近期疗效同步组有效率(ORR)为74.9%,单放组ORR为39.1%,差异有统计学意义(x^2=4.801,P<0.05)。同步组与单放组的1、2年生存率分别为72.0%、40.0%和69.6%、39.1%(x^2=0.034.P>0.05);1、2年无进展生存率分别为56.0%、24.0%和52.2%、21.7%(x^2=0.071,P>0.05),差异均无统计学意义,2组不良反应主要有放射性食管炎、放射性肺炎和骨髓抑制,同步组的发生率较单放组高,但差异无统计学意义(P>0.05),经对症处理后患者耐受良好。结论替吉奥联合三维适形放疗治疗中晚期食管胃结合部癌安全、有效,值得进一步扩大样本研究。Objective To investigate the effect and adverse reaction of Tijiao capsules（S-l） capsule plus radiotherapy on advanced esophageal and gastric cancer in gastro-esophageal junction.Methods 48 cases of advanced esophageal and gastric cancer were randomly divided into 2 groups;25 cases in synchronous group and solo radiotherapy group of 23 cases respectively.Two groups were treated by 6MV X-ray three dimensional conformal radiotherapy,total dose of 6 000 cGy/6weeks.Synchronous radiotherapy group first days with oral S-l,bid,14 d for 1 courses,7 d after stop taking S-l to start the next cycles.Results Except 1 case in synchronous group,the efficacy of synchronous group（ORR） was 74.9%,ORR of solo radiotherapy group was 39.1%respectively,the difference was statistically significant（x2 =4.801,P〈 0.05）.1st,2nd year survival rates of synchronous group and solo radiotherapy group were 72.0%,40.0%,69.6%and 39.1%（x2 =0.034,P〉 0.05）;1st,2nd years progression free survival rates of synchronous group and solo radiotherapy group were56.0%,24.0%,52.2%and 21.7%（x2 =0.071,P 〉 0.05）,no statistical significance difference were found.Adverse reactions of the 2 groups mainly are radiation esophagitis,radiation pneumonitis and bone marrow suppression,synchronous group occurred frequently than radiotherapy group,but the difference was not statistically significant（P 〉0.05）,patients showed good tolerance after symptomatic treatment.Conclnsion The S-l combined with three dimensional conformal radiotherapy in treatment of advanced esophageal and gastric cancer were safety,effective,worthy of further study with larger sample.

关 键 词：食管胃结合部肿瘤 放射治疗 替吉奥胶囊 治疗效果 不良反应 

分 类 号：R735[医药卫生—肿瘤]