调强放疗同步TP化疗对老年进展期食管癌的疗效观察及随访  

Observation and follow-up of intensity-modulated radiotherapy combined with TP chemotherapy of elderly patients with advanced esophageal cancer.

作　　者：葛曦[1] 郑杰[1] 杜小雷 朱艳丽[1] 赵玉魁 曹红霞 GE Xi;ZHENG Jie;DU Xiao-lei(Department 1 of Radiotherapy,General Hospital of Wanbei Coal Power Group of Anhui Suzhou,Suzhou Anhui 234000,China.)

机构地区：[1]安徽宿州皖北煤电集团总医院放疗一科,安徽宿州234000 [2]安徽医科大学第二附属院消化内科,安徽合肥230601

出　　处：《临床和实验医学杂志》2020年第16期1719-1723,共5页Journal of Clinical and Experimental Medicine

基　　金：安徽省卫生厅科研课题(编号:17HA01286)。

摘　　要：目的探讨调强放疗同步TP(多西他赛+顺铂)化疗对老年进展期食管癌的临床疗效,并随访观察患者生存情况及肿瘤复发、转移情况。方法选取2014年1月至2017年3月皖北煤电集团总医院收治的105例老年进展期食管癌患者开展前瞻性试验研究,采用随机数字表将其分为单一组(n=52)与联合组(n=53)。单一组患者给予调强放疗,联合组患者给予调强放疗同步TP化疗。对比两组患者的近期疗效及不良反应发生情况,并随访2年,统计患者1年、2年生存率及肿瘤复发率、远处转移率。结果联合组患者的近期总有效率(84.91%)明显高于单一组(65.38%),差异具有统计学意义(P<0.05);联合组治疗期间肝肾功能损伤、放射性食管炎、放射性肺炎、神经毒性及心脏损害的发生率(22.64%、64.15%、18.87%、11.32%、5.66%)与单一组(9.62%、51.92%、23.08%、3.85%、1.92%)比较,差异均无统计学意义(P>0.05);联合组患者的Ⅰ+Ⅱ级骨髓抑制、胃肠道反应及脱发的发生率(64.15%、43.40%、26.42%)明显高于单一组(42.31%、23.08%、7.69%),差异具有统计学意义(P<0.05);联合组患者的Ⅲ+Ⅳ级骨髓抑制、胃肠道反应及脱发的发生率(11.32%、3.77%、1.89%)与单一组(5.77%、0.00%、0.00%)比较,差异均无统计学意义(P>0.05);联合组患者的1年、2年总生存率(73.58%、54.72%)均高于单一组(48.08%、26.92%),差异具有统计学意义(P<0.05);联合组患者的1年、2年肿瘤复发率及远处转移率(18.87%、36.92%、7.55%、15.09%)均低于单一组(36.54%、61.54%、21.15%、34.62%),差异具有统计学意义(P<0.05)。结论调强放疗同步TP化疗可明显提高老年进展期食管癌患者的近期疗效,并可提高其生存率,减低肿瘤复发率、转移率,改善预后,另虽骨髓抑制、胃肠道反应等不良反应增加,但症状相对较轻,经积极对症干预后可缓解,患者能够耐受。Objective To investigate the clinical effect of intensity-modulated radiotherapy combined with TP chemotherapy(Docetaxel+Cisplatin)on elderly patients with advanced esophageal cancer,and to follow up the survival of patients and recurrence and metastasis of the cancer.Methods One hundred and five elderly patients with advanced esophageal cancer admitted to General Hospital of Wanbei Coal Power Group from January 2014 to March 2017 were selected to be carried out a prospective experimental research,who were divided into single group(n=52)and combined group(n=53)by random number table.The single group was given intensity-modulated radiation therapy,while the combined group was given intensity-modulated radiation therapy combined with TP chemotherapy.The short-term efficacy and adverse reactions were compared,then the patients were followed up for 2 years,and the 1-year and 2-year survival rates of patients and recurrence rate and distant metastasis rate of the tumors were calculated.Results The short-term total effective rate of the combined group(84.91%)was significantly higher than that of the single group(65.38%),and the difference was statistically significant(P<0.05).There was no significant difference in the incidence rates of liver and kidney damage,radiation esophagitis,radiation pneumonia,neurotoxicity and cardiac damage between the combined group(22.64%,64.15%,18.87%,11.32%,5.66%)and the combined group(9.62%,51.92%,23.08%,3.85%,1.92%)(P>0.05).The incidence rates of I+II grade bone marrow depression,gastrointestinal reaction and alopecia in the combined group(64.15%,43.40%,26.42%)were significantly higher than those in the single group(42.31%,23.08%,7.69%),and the differences were statistically significant(P<0.05).There was no significant difference in the incidence rates of III+IV grade bone marrow depression,gastrointestinal reaction and alopecia between the combined group(11.32%,3.77%,1.89%)and the single group(5.77%,0.00%,0.00%)(P>0.05).The 1-year and 2-year overall survival rates of the combined group

关 键 词：老年人 进展期食管癌 调强放疗 多西他赛 顺铂 临床疗效 生存率 

分 类 号：R735.1[医药卫生—肿瘤]