调强放疗同步多西他赛联合奥沙利铂化疗治疗Ⅲ/Ⅳ期食管癌的临床研究  

Clinical study of intensity modulated radiotherapy combined with Docetaxel and Oxaliplatin chemotherapy in the management of stage Ⅲ/Ⅳ esophageal cancer

作　　者：刘良忠[1] 李小红[2] 彭科瑜 张军[1] 张力[1] 常世川[1] LIU Liangzhong;LI Xiaohong;PENG Keyu;ZHANG Jun;ZHANG Li;CHANG Shichuan(Oncology Department,Chongqing Three Gorges Central Hospital,Chongqing 404000,China)

机构地区：[1]重庆三峡中心医院肿瘤科/重庆三峡消化系肿瘤防治研究所,重庆404000 [2]重庆三峡中心医院护理部,重庆404000

出　　处：《实用医学杂志》2019年第24期3808-3812,共5页The Journal of Practical Medicine

基　　金：重庆市区域医学重点学科建设项目(编号：ZDXK201919);重庆市万州区科技计划项目(编号：wzstc-2018003)

摘　　要：目的临床观察多西他赛联合奥沙利铂化疗同步调强放疗治疗Ⅲ/Ⅳ期食管癌的疗效。方法87例Ⅲ/Ⅳ期食管癌患者被随机分为对照组(替吉奥单药化疗同步调强放疗:46例)和研究组(多西他赛联合奥沙利铂化疗同步调强放疗:41例)。比较2组近期疗效、1年及2年生存率、不良反应及生活质量。结果研究组完全缓解率(CR)及客观有效率(CR+PR)分别为70.73%和87.90%,优于对照组30.43%和76.09%(P<0.05);研究组1年及2年生存率高于对照组(78.05%,51.21%vs.54.34%,19.57%),差异有统计学意义(P<0.05),而白细胞下降、贫血及消化道反应等不良反应发生率高于对照组(P<0.05),但经对症治疗后患者大部分患者可以完成治疗;放疗结束初期研究组QLQ-OES24评分低于对照组,而3个月后高于对照组(P<0.05)。结论多西他赛联合奥沙利铂为基础的同步放化疗可显著提高Ⅲ/Ⅳ期食管癌患者的近期疗效、生存率及远期生活质量,不良反应可耐受。Objective To investigate the effect of radiotherapy combined with Docetaxel and Oxaliplatin chemotherapy in the treatment of stage Ⅲ/Ⅳ esophageal cancer. Methods A total of 87 patients with stage Ⅲ/Ⅳesophageal cancer were recruited and randomly divided into the study group(n = 41)and control group(n = 46).Patients in the study group were given concurrent IMRT and chemotherapy combined by Docetaxel and Oxaliplatin,and patients in the control group were given IMRT and chemotherapy by S1.The short-term curative effect,1-year and 2-year of survival,adverse reactions and quality of life were compared. Results The complete response rate(CR)and objective effective rate(CR + PR)in the study group were 70.73% and 87.90%,respectively,which were significantly better than those in the control group(30.43% and 76.09%)(P < 0.05). The 1-year and 2-year survival of the study group were significantly higher than those of the control group(78.05%,51.21% vs 54.34%,19.57%)(P < 0.05),while the incidence of leukocyte decline,anemia,gastrointestinal reactions and other adverse reactions was significantly higher than that of the control group(P < 0.05). The QLQ-OES24 score of the study group was lower than that of the control group at the early stage after radiotherapy and higher than that of the control group after 3 months(P < 0.05). Conclusion Concurrent intensity modulated radiation therapy(IMRT)and combined with Docetaxel and Oxaliplatin chemotherapy could improve the short-term curative effect,survival rate and quality of life for patients with stage Ⅲ/Ⅳ esophageal cancer,and the adverse reactions could be tolerated.

关 键 词：食管癌 同步放化疗 调强放射治疗 多西他赛 奥沙利铂 

分 类 号：R73[医药卫生—肿瘤]