替吉奥联合调强放疗治疗老年食管癌的临床观察  

Clinical Observation of S-1 Combined with Intensity-modulated Radiotherapy in the Treatment for Elder Patients with Esophageal Cancer

作　　者：黄雪[1] 周希法[1] 李红波[1] 马燕[1] 杨丹[1] 

机构地区：[1]苏州大学附属常州肿瘤医院,江苏常州213001

出　　处：《肿瘤学杂志》2015年第8期659-662,共4页Journal of Chinese Oncology

基　　金：常州市科技计划项目(CJ20112019)

摘　　要：[目的]研究替吉奥联合调强放疗治疗老年食管癌的疗效及不良反应。[方法]选择52例老年Ⅱ～Ⅲ期食管癌患者,随机分为替吉奥联合调强放疗组（放化疗组）26例和单纯调强放疗组（单放组）26例。两组患者均行调强放疗（IMRT）DT58～66Gy/29～33f,放化疗组在放疗第1天联合替吉奥化疗40mg/m2,一天2次,早、晚餐后口服,d1～14,休息7d,21d为1个周期,共2个周期。[结果]52例患者均可评价疗效。放化疗组的近期总有效率为84.6%,单放组为65.3%,差异无统计学意义（P〉0.05）。放化疗组1、2年生存率为80.7%和57.6%,单放组1、2年生存率为57.6%和34.6%,差异均有统计学意义（P〈0.05）。两组不良反应均以Ⅰ～Ⅱ反应为主,主要表现为骨髓抑制、消化道反应、放射性食管炎和放射性肺炎,两组比较差异无统计学意义（P〉0.05）,经处理后均能顺利完成治疗。[结论]替吉奥联合调强放疗治疗老年食管癌,虽然近期疗效差异不显著,但1、2年生存率有明显提高,而不良反应无明显增加,是老年食管癌较为理想可行的治疗方法,值得临床进一步推广。[Purpose] To investigate the efficacy and adverse sides of S-1 combined with intensitymodulated radiotherapy in the treatment for elder patients with esophageal cancer. [Methods]A total of 52 elder patients with esophageal cancer were randomized into two groups ：26 patients treated with chemoradiotherapy and the other 26 patients treated with radiotherapy alone. The schedules of radiotherapy in two groups were intensity-modulated radiotherapy（IMRT） in conventional fractionation.The total dose was 58～66Gy/29～33f for all patients. Chemoradiotherapy group received S-1 treatment by 40mg/m2 bid after meals,since the first day of radiotherapy with chemotherapy simultaneously,and administration for 14 days followed by 7 days rest,while 21 days as a cycle. There were 2 cycles during radiotherapy. [Results] The efficacy of 52 patients could be evaluated. In the patients of chemoradiotherapy group,the short-term effective rate was84.6% while the radiotherapy alone group was 65.3%,with no statistic significance（P〉0.05）. The1-,2- year survival rates of chemoradiotherapy group were 80.7% and 57.6%,and the radiotherapy group were 57.6% and 34.6% respectively. The survival rates of the two groups had statistic significance（P〉0.05）.The major adverse sides in the two groups were myelosuppression,digestive tract reaction,radioation esophagitis and radioation pneumonitis,mainly grade 1 ～2.The adverse sides between the two groups showed no difference（P〉0.05）.[Conclusion] The short-term efficacy of S-1 combined with IMRT for elder patients with esophageal cancer is not improved,but the 1-,2- year survival rates of the two groups have statistic significance,and the adverse sides are not increased. So,it is an ideal,feasible method,and is worth to the clinical further promotion.

关 键 词：食管肿瘤 放射治疗 替吉奥 老年 

分 类 号：R735.1[医药卫生—肿瘤]