老年食管癌三维适形放疗与调强放疗同步奈达铂化疗疗效观察  

Effect observation of nedaplatin concurrent chemotherapy and three-dimensional conformal radiotherapy or intensity modulated radiotherapy for elderly patients with esophageal cancer

作　　者：段伟[1] 刘宁宁[1] 高娜[1] 乔健[1] 

机构地区：[1]延安大学附属医院肿瘤科,陕西延安716000

出　　处：《现代医学》2015年第2期187-190,共4页Modern Medical Journal

摘　　要：目的:观察老年食管癌三维适形放疗与调强放疗同步奈达铂化疗的临床治疗效果及长期生存率。方法:68例初治食管癌患者为研究对象,按照数字表随机分为三维适形放疗(A组)34例,调强放疗(B组)34例,两组均给予奈达铂25 mg·m-2·周-1同步化疗,每周1次,放疗d 1、8、15、22、29、36用药,共6周,在此基础上A组给予三维适形放疗,B组给予调强放疗。观察两组临床治疗效果及长期生存率情况。结果:A组有18例完成了同步放化疗,其余患者因副反应重未继续给予奈达铂,但均完成了放疗。B组有20例完成了同步放化疗,其余患者未继续给予奈达铂,完成了单纯放疗。放疗结束疗效评价,A、B组分别为CR 17.6%vs23.5%,PR 52.9%vs 58.8%,总有效率(CR+PR)为70.6%vs 82.4%。两组疗效比较差异无统计学意义(P>0.05);两组毒性反应比较,差异无统计学意义(P>0.05)。两组1、2、3年生存率分别为63.0%、41.0%和31.2%,64.3%、42.7%和33.0%,两组患者生存率比较差异无统计学意义(P>0.05)。结论:老年食管癌患者行三维适形放疗或调强放疗近期疗效及远期生存率无明显差异,但放射性食管炎及放射性肺炎B组更低,提示调强放疗似乎在老年食管癌中可能更具有优势。Objective： To compare the efficacy and survival rates of esophageal carcinoma with nedaplatin concurrent chemotherapy and three- dimensional conformal radiotherapy（ 3D- CRT） or intensity modulated radiotherapy（ IMRT） for elderly patients. Methods： From Jan 2010 to Dec 2010,68 cases with pathologically proved esophageal carcinoma were randomly divided into 3D-CRT group（ group A） and IMRT group（ group B）based on random number method. Patients in both groups received weekly nedaplatin 25 mg·m- 2begun at the d1 of radiotherapy. Results： 18 cases among 34 patients in groups A received six weeks nedaplatin concurrent chemotherapy,the others wouldn＇t finish 6 weeks nedaplatin chemotherapy because of severe adverse effects. 20 cases in group B received six weeks concurrent chemotherapy. After the treatment,the CR rate（ CRR） in group A and B was 17. 6% and 23. 5%,respectively（ P〉0. 05）; and the PR rate（ PRR） was 52. 9% and 58. 8%,respectively（ P〉0. 05）. The overall response rate（ CR plus PR） was 70. 6% and 82. 4%,respectively（ P〉0. 05）. There were no significant differences in toxicity in two groups. The 1-and 2-and 3-years survival rate were 63. 0%,41. 0% and 31. 2%（ group A）; 64. 3%,42. 7% and 33. 0%（ group B）,respectively（ P〉0. 05）. Conclusion：The efficacy and survival rate of group A and group B are similar,hower,for the rate of radiation induced esophagitis and pneumonitis,the group B is lower than group A.

关 键 词：老年食管癌 三维适形放疗 调强放疗 奈达铂 

分 类 号：R735.1[医药卫生—肿瘤] R815[医药卫生—临床医学]