图像引导下的调强放疗同步每周多西他赛联合顺铂治疗局部晚期食管癌临床观察  

Image-guided intensive-modulated radiotherapy concurrent weekly docetaxel and cisplatin for local advanced esophageal cancer: a retrospective study

作　　者：段奇文[1] 刘俊华[2] 王道梅[1] 胡承浩[1] 吴峰[1] 邱力[1] 骆志国[1] 

机构地区：[1]湖北医药学院附属太和医院肿瘤科III病区,442000 [2]湖北医药学院附属太和医院,442000

出　　处：《现代消化及介入诊疗》2015年第2期85-88,共4页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：十堰市太和医院中青年科技创新团队项目(2012TD01)

摘　　要：目的回顾性分析图像引导下的调强放疗同步每周多西他赛联合顺铂治疗局部晚期食管癌的有效性和安全性。方法自2009年1到2012年5月本院收治的86例局部晚期食管癌初治病例,所有病例均经病理学确诊为食管癌。治疗组选择放疗同步每周多西他赛联合顺铂方案化疗,选择单纯放疗患者作为对照组,放疗剂量60 Gy。对比分析两组的有效率、2年生存率、毒副反应以及失败原因。结果近期总有效率同步放化疗组为84.1%,单纯放疗组为62.3%,两组之间差异有统计学意义(P<0.05);1年、2年生存率单放组50.5%(21/42)、31.3%(13/42),同步放化组为72.8%(32/44)、52.3%(23/44),两组之间差异有统计学意义(P<0.05)。与对照组相比,治疗组的血液学毒性明显发生率高(P<0.05);但是通过对症支持治疗后患者能够完成治疗过程。两组治疗失败的最大原因还是局部失败,表现在野内复发或者未控。结论图像引导下的调强放疗同步每周多西他赛联合顺铂比单纯放疗有效,每周化疗方案毒副反应耐受性好。放疗剂量提高到60 Gy同步化疗未发现治疗相关的死亡,对局部病灶控制以及症状控制效果好。Objective To investigate the effect and safety of image-guided intensive-modulated radiotherapy concurrent weekly docetaxel and cisplatin（CRT） for local advanced esophageal cancer retrospectively. Methods Eighty-six esophageal cancer patients were confirmed by pathology from January 2009 to May 2012and were both initial treatment cases. The study group received image-guided intensive-modulated radio- therapy concurrent weekly docetaxel and cisplatin, and the control group received radiotherapy alone. Two groups received radiation therapy with a dossge of 60Gy. The clinical efficacy, side effects, and the modes of failures were compared between two groups. Results The response rate was 84.1% for chemoradiotherapy group, and 62.3% for radiotherapy group, and there was significant difference between two groups （P 〈 0.05）. 1, 2 years survival rate for chemoradiotherapy group and radiotherapy group were 72.8%（32/44）, 52.3% （23/ 44）, and 50.5%（21/42）,31.3%（13/42）, respectively （P 〈 0.05）. The incidence of haematological toxicity in chemoradiotherapy group was significantly higher than that in the control group （P 〈 0.05）, but the whole treatment could be finished due to support therapy. The major failures of treatment were cancer recurrence in target fields. Conclusion Concurrent CRT with weekly docetaxel and cisplatin was well tolerated, and therefore, was a convenient combination with promising efficacy.

关 键 词：同步放化疗 图像引导下放疗 调强放疗 食管癌 

分 类 号：R735.1[医药卫生—肿瘤]