替吉奥联合伽马刀治疗食管癌腹膜后淋巴结转移的临床观察  

The clinical observation of the tegafur combined with body gamma knife in the treatment of esophageal neoplasm complicated with retroperitoneal lymph node metastasis

作　　者：葛宁[1] 詹必红[1] 常娜[1] 臧春宝[1] 

机构地区：[1]安徽省肿瘤医院放疗科,安徽合肥230031

出　　处：《蚌埠医学院学报》2015年第10期1346-1349,共4页Journal of Bengbu Medical College

摘　　要：目的：探讨替吉奥（S1）联合体部伽马刀治疗食管癌腹膜后淋巴结转移的疗效及不良反应.方法：回顾性分析69例食管癌腹膜后淋巴结转移患者临床资料,体部伽马刀治疗时用真空垫和三维立体定向体架固定,增强CT扫描,肿瘤靶区外扩10 mm为计划靶区,50%等剂量线包绕95%计划靶区为处方剂量线,每次350~450 cGy,5次/周.10~12次完成.肿瘤边缘总剂量：4 200~4 950 cGy.69例中联合组36例,行体部伽马刀治疗联合口服S1 40 mg/m2 ,2次/天,口服21 d,28 d为1个周期,口服4个周期;对照组33例,单纯行体部伽马刀治疗.结果：联合组近期总有效率和1年生存率分别为86.11%、77.78%,对照组分别为63.63%、54.54%,联合组1 年生存率高于对照组（P〈0.05）.联合组疼痛缓解总有效率为91.18%,对照组77.42%,差异无统计学意义（P〉0.05）.2组患者治疗过程中的急性不良反应差异均无统计学意义（P〉0.05）,患者均可耐受,经积极治疗可好转,未发生治疗相关性病死亡.结论：S1联合体部伽马刀治疗食管癌腹膜后淋巴结转移可提高1年生存率,不良反应无明显增加.Objective：To evaluate the effects and adverse reactions of the tegafur combined with body gamma knife in the treatment of patients with esophageal neoplasm complicated with retroperitoneal lymph node metastasis. Methods：The clinical data of 69 esophageal neoplasm patients with retroperitoneal lymph node metastases were retrospectively analyzed. Fixing vacuum pad and three-dimensional stereotactic body,enhancing CT scan,enlarging the tumor target area for 10 mm as planning target area,50% dose line embracing 95%planning target area as prescription dose curve and 350 to 450 cGy one time（5 times a week） were implemented at the time of body gamma knife therapy. The treatment was consist of 10 to 12 times,and the total dose of the tumor margin was 4 200-4 950 cGy. Among 69 cases,36 patients（combination group） were treated with the body gamma knife combined with tegafur（40 mg/m2,2 times 1 d, 28 days 1 cycle for 4 cycles） ,33 patients（ control group） were only treated with the body gamma knife therapy. Results：The short-term effective rate and 1-year survival rate in the combination group and control group were 86. 11% ＆amp;77. 78% and 63. 63% ＆amp;54. 54%, respectively. The 1-year survival rate in the combination group was higher than that in the control group（P〈0. 05）. The total effective rate of pain relief in the combination group and control group were 91. 18% and 77. 42%,respectively,the difference of which was not statistically significant（P〉0. 05）. The difference of the acute adverse reaction between two groups was not statistically significant（P〉0. 05）. The patients could tolerate,and were improved after positive treatment. No case died. Conclusions：The treatment of patients with esophageal neoplasm complicated with retroperitoneal lymph node metastasis with tegafur combined with body gamma knife treatment can improve 1-year survival rate,and does not increase the adverse reaction of patients.

关 键 词：食管肿瘤 腹膜后转移瘤 替吉奥 伽马刀 

分 类 号：R735.1[医药卫生—肿瘤]