卡培他滨增敏联合后程加速超分割放射治疗食管癌的疗效观察

Capecitabine combined with late course accelerated hyperfractionated radiotherapy for esophageal cancer

目的探讨口服卡培他滨增敏联合后程加速超分割（简称后超）放射治疗食管癌的近期疗效、生存期及毒副反应。方法将82例食管癌患者随机分为后超＋卡培他滨组（治疗组）和单纯后超组（对照组）。放疗前2／3疗程常规分割，即2Gy/次，5次，周，共40Gy，后1/3疗程1．5Gly/次，2次/d，间隔6h或以上，5d／周，总剂量65～70Gy。治疗组自放疗第1d开始口服卡培他滨1000mg/m^2,2次/d，连续服用14d，休息7d，治疗周期为21d，共治疗2个周期。结果82例患者全部完成治疗计划，治疗组和对照组近期疗效分别为89．7％和76．9％，差异有统计学意义（P〈0．05），1年生存率分别为80．5％和73．2％（P〉0．05），放射性食管炎和骨髓抑制的发生率，两组差异无统计学意义。结论口服卡培他滨增敏联合后程加速超分割放疗可提高食管癌的近期疗效，未增加毒副反应，耐受性良好．远期疗效仍需进一步观察。

Objective To evaluate the response, survival and toxicity of eapecitabine combined with late course accelerated hyperfractionated radiotherapy（LCAHR） for esophageal cancer. Methods Eighty-two patients were randomly divided into two groups： 41 patients in the treatment group received capocitabine combined with LCAHR, and the other 41 patients in the control group received only LCAHR. All patients were treated by conventional fractionated radiotherapy during the first two-thirds of the whole course with 40Gy in 20 fractions, followed by LCAHR with 25-30 Gy in 17-19 fractions, 1.5 Gy per fraction, twice a day, with an interval of more than 6 hours between fractions to a total dose of 65-70 Gy. The treatment group took 1 000 mg/m^2 capocitabine twice a day for fourteen days followed by a 7-day rest period from the first day of radiotherapy, every 3 weeks as one cycle, totally 2 cycles. Results All patients completed treatment courses. The short-term response rate of the treatment group and the control group was 89.7% and 76.9% respectively with statistically significant differences. The 1-year survival rate was 80.5% and 73.2% in the treatment and control groups respectively（ P 〉 0.05）. As for acute radiation esophagitis and myelnsuppression, there were no significant differences between the two groups. Conclusions Capecitabine combined with late course accelerated hypeffractionated radiotherapy for esophageal cancer can improve the short-term response rate. Its side effects are not statistically different from those of LCAHR alone and are tolerable, however its long-term results need further study in the clinic.