沙利度胺联合同步放化疗治疗不宜手术食管癌的疗效和不良反应  

Efficacy and adverse reactions of thalidomide combined with concurrent chemoradiotherapy in the treatment of inoperable esophageal cancer

作　　者：韩光锋[1] 李承慧[1] HAN Guangfeng;LI Chenghui(Department of Oncology,Anqing Hospital Affiliated to Anhui Medical University,Anhui Anqing 246003,China)

机构地区：[1]安徽医科大学附属安庆医院肿瘤内科,安徽安庆246003

出　　处：《现代肿瘤医学》2022年第16期2929-2932,共4页Journal of Modern Oncology

基　　金：安徽医科大学校科学研究基金资助项目(编号:2019xkj227)。

摘　　要：目的:探讨沙利度胺对食管癌同步放化疗疗效和不良反应的影响。方法:选取82例食管癌患者,随机分为研究组和观察组,研究组治疗方案为沙利度胺联合同步放化疗,观察组为同步放化疗,同步放化疗中放疗单次剂量180~200 cGy,每周5次,给予放疗总量6000~6120 cGy/30~34次,同步化疗方案为紫杉醇135 mg/m^(2) d_(1)+顺铂25 mg/m^(2) d_(1)~d_(3),28天为1个周期,同步放化疗期间化疗2个周期,放化疗结束后再全身化疗2个周期。实验组患者在放化疗的基础上每日口服沙利度胺100 mg。观察两组患者近期疗效、长期生存及毒副作用。结果:研究组有效率为77.5%,观察组有效率为71.4%,P=0.529。研究组患者OS为43个月,观察组患者OS为45个月,P=0.783,差异无统计学意义。研究组中有14例发生放射性肺炎,发生率35%,观察组有24例发生,发生率为57%,P=0.044,差异有统计学意义。在放射性食管炎、放射性皮肤损伤、放射性气管炎方面,两组比较均无统计学差异。结论:在食管癌同步放化疗中加用沙利度胺不能提高近期有效率和远期生存,但可以减少放射性肺炎发生率。Objective:To investigate the efficacy of thalidomide on concurrent chemoradiotherapy and adverse reactions in patients with esophageal cancer.Methods:82 patients with esophageal cancer were selected and randomly divided into study group and observation group.The study group was treated with thalidomide 50 mg,twice a day,combined with concurrent chemoradiotherapy,while the control group was treated with concurrent chemoradiotherapy.The single dose of radiotherapy during concurrent chemoradiotherapy was 180~200 cGy/f,5 times a week,and the total amount of radiotherapy was 6000~6120 cGy/30~34 f.The chemotherapy regimen was taxol 135 mg/m^(2) and cisplatin 25 mg/m^(2),The patients received 2 cycles of concurrent chemotherapy during radiotherapy,followed by systemic chemotherapy for 2 cycles after the end of concurrent chemoradiotherapy.The experimental group received thalidomide 100 mg orally,on the basis of chemoradiotherapy.Efficacy,survival and side effects of the two groups were observed.Results:The response rate was 77.5%in the study group and 71.4%in the observation group,P=0.529.In the study group,OS was 43 months,while in the observation group,OS was 45 months,P=0.783,and the difference was not statistically significant.There were 14 cases of radioactive pneumonia in the study group,with an incidence of 35%,and 24 cases in the observation group,with an incidence of 57%,with a P value of 0.044,the difference was statistically significant.There was no statistical difference between the two groups in radiation esophagitis,radiation skin injury and radiation tracheitis.Conclusion:The addition of thalidomide to concurrent chemoradiotherapy for esophageal cancer can not improve the short-term effective rate and long-term survival,but can reduce the incidence of radioactive pneumonia.

关 键 词：食管癌 放化疗 沙利度胺 

分 类 号：R735.1[医药卫生—肿瘤]