时辰化疗联合放疗治疗晚期贲门癌

Chrono-chemotherapy with radiotherapy in treatment of advanced cardiac carcinoma

目的:探讨时辰化疗联合放疗治疗晚期贲门癌的疗效。方法:晚期贲门癌患者85例,随机分为单放组和综合组,综合组40例,时辰化疗采用顺铂(DDP)联合5氟尿嘧啶(5-FU)静脉输入,DDP20mg/m2,10时至22时给药,5-FU600mg/m2,22时至翌日10时给药,疗程5天,间隔16天重复。时辰化疗同时予以放射治疗,靶区剂量(DT)60Gy^65Gy,6~7周照射;单放组45例,常规放疗DT70Gy/7周,观察患者治疗的效果及影像改善情况,随访6~24个月。结果:综合组和单放组梗阻症状改善率分别为90%(36/40)及66%(33/45),两组差异有统计学意义(P<0.05);X线好转率分别为85%(34/40)及68%(31/45)(P>0.05);综合组和单放组患者1、2年生存率分别为75%(30/40)和53.3%(24/45)(P<0.05),40%(16/40)和28.9%(13/37)(P>0.05)。结论:时辰化疗联合放疗是一种治疗晚期贲门癌的有效方法。

Objective： To investigate the treatment effects of chrono - chemotherapy（CC） with radiotherapy on advanced cardiac carcinoma. Methods： Eighty - five patients with advanced cardiac carcinoma were randomly advided into two groups： 40 patients were treated by chrono - chemotherapy（cc） plus radiotherapy（R） , chrono - chemotherapy group were chrono intr - vein infusion with cisplatin and 5 - fluorouracil. Patients were given cisplatin 20/m^2 infusion on 10 - hour - 22 - hour, Patients were given 5 - fluorouracil 600/m^2 by infusion on 22 - hour - 10 - hour next day. The period of treatment was 5 days;Treatment was vepeated every 21 days. The radiotion dose was 60 ～ 65Gy,for 6 ～ 7 weeks（ CC ＋ R） ,45 patients received radical radiotherapy alone（R） ,the radiotion dose was 70Gy,for 7 weeks. All patients were followed up for 6 to 24 months. Results： The improvements of clinical symptoms were 90% （36/45） in CC ＋ R group and 73.3% （33/45） in R group, with an obvious difference between the two groups（P 〈 0.05 ）. The improvements of obstruction on barium meal were 85.0% （34/40） in CC ＋ R group and 68.8% （31/45） in R group（ P 〉 0. 05 ）. The 1 - ,2 - year survival rates were 75.0% （30/40） and 53.3% （24/45） ,40.0% （16/40） and 28.9% （13/37） in two groups, with significant difference in 1 - year survival rate between two groups（P 〈 0.05）. Conclusion： Radiotherapy combined with CC ＋ R was an effective method for advanced cardiac carcinoma.