卡培他滨联合调强适形放射治疗对老年食管癌根治术后局部复发的影响  

Effect of Capecitabine Combined with IMRT on Local Recurrence after Radical Operation in Elderly Patients with Esophageal Cancer

作　　者：潘华英[1] 王爱华[1] 赵静[1] 刘荣英[1] 江艳[1] 

机构地区：[1]湖北医药学院附属太和医院肿瘤科,湖北十堰442000

出　　处：《中国药业》2014年第15期107-109,共3页China Pharmaceuticals

摘　　要：目的：观察卡培他滨联合调强适形放射治疗（IMRT）对老年食管癌患者根治术后局部复发的影响。方法选择2010年3月至2012年3月就诊并接受食管癌根治术的局部复发患者126例，随机分为对照组和治疗组，各63例。对照组给予5-氟尿嘧啶500 mg / d 和三维适形放射治疗（3D - CRT），2 Gy / d，每天1次，每周5次；治疗组给予卡培他滨1000 mg / m2，口服2次，1~14 d 联合 IMRT，50~65 Gy，以3周为1个周期，两组疗程均为6周，观察并记录近期疗效、转移复发率、远期疗效的指标及药品不良反应和放射反应。结果治疗组总有效率为90.48%，显著高于对照组的77.78%（ P ﹤0.05）；两组治疗转移复发率差异无统计学意义；治疗组远期疗效明显优于对照组（ P ﹤0.05）；两组患者不良反应较轻且在可控范围内，两组患者1~2度骨髓抑制、1~2度胃肠道反应、1~2度手足综合征发生率无明显差异，治疗组放射性食管炎、放射性肺炎发生率均显著低于对照组（ P ﹤0.05）。结论卡培他滨联合 IMRT 在老年食管癌患者根治术后局部复发的治疗中，近期有效率和局部控制率高，远期疗效好，不良反应较轻且放射反应较发生率低，值得临床推广。Objective To observe the effect of capecitabine combined with the intensity modulated radiation therapy（IMRT） on local re-currence after radical operation in elderly patients with esophageal cancer. Methods 126 patients with local recurrence after esophageal cancer radical resection in our hospital from March 2010 to March 2012 were selected and randomly divided into the treatment group and the control group, 63 cases in each group. The control group received 5 - fluorouracil 500 mg / d and the three - dimensional confor-mal radiotherapy（3D - CRT）, 2 Gy / day, once daily, 5 times a week; the treatment group received capecitabine 1 000 mg / m2, orally twice daily on 1 - 14 d, and combined with IMRT, 50 - 65 Gy, 3 weeks as 1 cycle. Both groups had the same treatment course of 6 weeks. The short term effect, metastasis and recurrence rates, indicators of long - term efficacy, adverse drug reactions and radiation reaction were ob-served and recorded. Results The total effective rate was 90. 48% in the treatment group, which was significantly higher than 77. 78%in the control group（ P ﹤ 0. 05 ）; the metastatic recurrence rate in the two groups had no statistically significant difference; the long - term efficacy in the treatment group was superior to the control group（ P ﹤ 0. 05 ）; the adverse reactions in the two groups were mild and within the controllable range, the occurrence rates of 1 - 2 degree of myelosuppression, 1 - 2 degree of gastrointestinal reactions and 1 -2 degree of hand - foot syndrome had no statistically significant difference, the occurrence rate of radiation esophagitis and radiation pneumonitis in the treatment group were significantly lower than that in the control group（ P ﹤ 0. 05） . Conclusion Capecitabine com-bined with conformal IMRT in treating local recurrence after radical operation in elderly patients with esophageal cancer has high ef-fective rate in the short term therapy, high local control rate, good long - term efficacy, mild adverse reactions and low occu

关 键 词：卡培他滨 5-氟尿嘧啶 调强适形放射治疗 三维适形放射治疗 

分 类 号：R969.4[医药卫生—药理学] R979.1[医药卫生—药学]