替吉奥联合顺铂同步三维适形放疗治疗中晚期食管癌的临床研究  

Clinical study of advanced esophageal cancer treated by S-1 plus cisplatin combined with three dimensional conformal radiotherapy

作　　者：时亚伟[1] 吴朝阳[1] 薛春泉[1] 

机构地区：[1]江苏省镇江市第一人民医院放疗科,江苏镇江212002

出　　处：《中国当代医药》2014年第25期102-104,109,共4页China Modern Medicine

摘　　要：目的：观察替吉奥联合顺铂（SP方案）同步三维适形放射（3DCRT）治疗中晚期食管癌的近期效果与毒副反应。方法将确诊为鳞癌的42例中晚期食管癌患者随机分为观察组（SP同步3DCRT）和对照组（氟尿嘧啶＋顺铂同步3DCRT），每组各21例。观察组化疗方案：替吉奥50 mg/（m2·d），分2次口服，第1~14天，顺铂25 mg/（m2·d）第1~3天，28 d为1个周期，共2个周期；对照组给予氟尿嘧啶500 mg/（m2·d）第1~5天，顺铂25 mg/（m2·d）第1~3天，28 d为1个周期，共2个周期；所有患者均同步接受3DCRT，比较两组患者近期疗效及毒副反应的差异。结果观察组患者的有效率为85.7%，对照组为71.4%，两组差异无统计学意义（P〉0.05）。观察组患者的骨髓抑制及消化道反应发生率均低于对照组，差异有统计学意义（P〈0.05），两组患者放射性食管炎的发生率差异无统计学意义（P〉0.05）。结论 SP方案同步放疗治疗中晚期食管癌的近期效果较氟尿嘧啶＋顺铂方案无显著提高，但其安全性较好，有希望成为中晚期食管癌同步放化疗方案的新选择。Objective To observe the short-term efficacy and toxicity of S-1 plus cisplatin combined with three dimen-sional conformal radiotherapy （3DCRT） treatment for advanced esophageal cancer. Methods 42 patients with esophageal squamous cell carcinomas were randomly divided into observation group （SP combined with 3DCRT） and control group （fluorouracil plus cisplatin combined with 3DCRT）,each group of 21 cases.The observation group was treated with S-1 50 mg/（m2·d） orally bid on day 1-14 plus cisplatin 25 mg/（m2·d） on day 1-3,repeated for 28 days.The control group was treated with fluorouracil 500 mg/（m2·d） on day 1-5 and cisplatin 25 mg/（m2·d） on day 1-3,repeated for 28 days. All patients completed two cycles of chemotherapy.The difference between the two groups in the short-term efficacy and toxicity were compared. Results The efficacy rate in observation group was 85.7% and the control group was 71.4%,there was no statistically significant difference （P〉0.05） between the two groups.The bone marrow inhibition and gastrointestinal reaction in observation group were lower than those in the control group,the difference was statistically significant （P〈0.05）,the incidence of radioactive esophagitis had no statistically significant difference between the two groups （P〉0.05）. Conclusion The recent effect of SP plan synchronous radiation therapy in the treatment of patients with advanced esophageal cancer compare the fluorouracil plus cisplatin plan is no significant increases,but its security is better,there is hope chemoradiation solutions become a new options for advanced esophagus cancer.

关 键 词：氟尿嘧啶 顺铂 食管癌 三维适形放疗 同步放化疗 

分 类 号：R735.1[医药卫生—肿瘤]