三维适形放疗联合雷替曲塞加奥沙利铂治疗中晚期食管鳞癌的临床观察  

Observation of raltitrexed and oxalipatin combined with three-dimensional conformal radiotherapy for advanced esophageal cancer

作　　者：李德凡[1] 杨帆[1] 蒋淑年[1] 徐秀娟[1] 刘冰[1] 严庆芳[1] 

机构地区：[1]江苏省连云港市肿瘤医院放疗科,江苏连云港222023

出　　处：《临床肿瘤学杂志》2015年第1期57-60,共4页Chinese Clinical Oncology

摘　　要：目的观察三维适形放疗联合化疗治疗中晚期食管鳞癌的近期疗效和不良反应。方法收集2011年9月至2013年4月间中晚期食管鳞癌患者42例,采用三维适形放疗联合化疗,放疗剂量：60 Gy/30次,6周完成;化疗方案为：雷替曲塞3 mg/m^2,静滴,d1;奥沙利铂130 mg/m^2,静滴2 h,d2,28天为1周期。放疗第1周和第5周时各化疗1周期,放疗结束后4-6周开始继续原方案巩固化疗2周期。结果 42例患者均可评价疗效,获完全缓解18例（42.9%）、部分缓解23例（54.8%）和稳定1例（2.4%）,总有效率为97.6%。1、2年局部控制率为90.5%、71.4%,1、2年生存率为85.7%、60.7%。全组患者的不良反应多为1-2级,急性食管炎、急性放射性肺炎、胃肠道反应、骨髓抑制及肝功能损害发生率分别为95.2%、23.8%、73.8%、42.9%和19.1%。结论三维适形放疗联合雷替曲塞和奥沙利铂治疗中晚期食管鳞癌的近期疗效显著,局部控制率较好,毒副反应能耐受,长期疗效有待进一步观察。Objective To explore the efficacy and toxic reaction of three-dimensional conformal radiotherapy（ 3DCRT） with chemotherapy for advanced esophageal cancer. Methods From September 2011 to April 2013,42 patients were treated by 3DCRT（ DT： 60 Gy） and concurrent chemotherapy using raltitrexed（ 3 mg/m^2,d1） and oxalipatin（ 130 mg/m^2,d2） with a 28-day cycle. The concurrent chemotherapy lasted for 2 cycles. After radiotherapy,2 cycles of the same regimen for consolidation chemotherapy were used4-6 weeks later. Results All patients finished the radiochemotherapy and got complete remission in 18 cases（ 42. 9%）,partial remission in 23 cases（ 54. 8%） and stable disease in 1 case（ 2. 4%） with the rate of total efficiency of 97. 6%. The 1-and 2-year local control rates and survival rates were 90. 5%,71. 4% and 85. 7%,60. 7%. Main side effects were grade 1-2. The incidence of acute esophagitis,acute radiation pneumonia,gastrointestinal reaction,bone marrow depression and liver function injury were 95. 2%,23. 8%,73. 8%,42. 9% and 19. 1%,respectively. Conclusion Raltitrexed and oxalipatin combined with 3DCRT for advanced esophageal cancer patients is effective and well-tolerated. The value of addition of concurrent radiochemotherapy for advanced esophageal cancer needs further investigation.

关 键 词：食管癌 放射治疗 化学治疗 三维适形 雷替曲塞 奥沙利铂 

分 类 号：R735.2[医药卫生—肿瘤]