调强放疗联合紫杉醇加奈达铂及重组改构人肿瘤坏死因子α治疗局部进展期食管癌的近期疗效临床观察  

Short-term efficacy of concurrent chemoradiotherapy of IMRT combined with TP regimen and modified rhTNF-a in the treatment for locally advanced esophageal carcinoma

作　　者：陈丽[1] 汪步海[1] 袁一枫[1] 蒋亚齐[1] 戴尔珣[1] 郭隽[1] 邢恩明 

机构地区：[1]江苏省苏北人民医院肿瘤科,江苏扬州225001

出　　处：《癌症进展》2016年第11期1121-1123,1127,共4页Oncology Progress

摘　　要：目的探讨调强放疗(IMRT)联合紫杉醇加奈达铂(TP)及注射用重组改构人肿瘤坏死因子α(rh TNF-α)治疗食管癌的近期疗效及安全性,并评价食管癌部位与食管狭窄的相关性。方法对40例罹患不同部位食管癌的患者进行IMRT+TP方案+rh TNF-α治疗。评价近期疗效及不良反应,另外,按食管癌发生部位将患者分为颈胸上段组和胸中下段组,进一步比较两组的近期疗效和不良反应以及食管狭窄情况。结果 40例患者中CR 20例(50%),PR 16例(40%),总有效率为90%(36/40)。治疗相关血液学不良反应以白细胞减少为主,非血液学不良反应均较轻微。治疗后食管癌颈胸上段组和胸中下段组的中度及以上食管狭窄发生率分别为63.64%(14/22)和11.11%(2/18),差异有统计学意义(P﹤0.001)。结论食管癌同步放化疗联合重组改构人肿瘤坏死因子α治疗食管癌疗效确切,不良反应均可耐受,但颈胸上段食管癌放疗后食管狭窄程度较重,应加以重视。Objective To explore the effectiveness and safety of concurrent intensity-modulated radiotherapy （IMRT） combined with paclitaxel plus nedaplatin （TP） and modified recombinant human tumor necrosis factor-α（rhTNF-α） in pa-tients with locally advanced esophageal carcinoma （EC）. Method 40 patients with esophageal cancer were included in the study, and all were administered with IMRT＋TP and rhTNF-α. The short-term efficacy and toxicities were evaluated, and then patients were stratified as cervical/upper-thoracic EC group and mid-/lower-thoracic EC group, for which the short-term efficacy and toxicities, as well as the occurrence of esophageal strictures were further compared. Result In the 40 patients, there were 20（50%） cases of CR, 16（40%） cases of PR, and the ORR was 90%（36/40）. Leucopenia was the most common hematological toxicity seen in all patients, and non-hematological toxicities were mild. After treatment, the incidence of moderate-to-severe esophageal strictures were 63.63%（14/22） and 11.11%（2/18） in cervical/upper-thorac-ic and mid-/lower-thoracic groups, respectively, with statistically significant difference observed （P〈0.001）. Conclusion The concurrent chemoradiotherapy of IMRT combined with TP regimen and rhTNF-αis fairly effective in patients with locally advanced esophageal cancer, with tolerable toxicities; Besides, patients with cervical/upper-thoracic esophageal cancer are more likely to develop esophageal stricture, which is of clinical significance.

关 键 词：食管癌 同步放化疗 肿瘤坏死因子 

分 类 号：R735.1[医药卫生—肿瘤]