中晚期食管癌希罗达加三维适形同期放化疗的近期临床疗效分析

Prospective Clinical Study about Capecitabine combined with conformal radiation therapy for advanced esophageal cancer

目的探讨口服希罗达增敏联合三维适形放射治疗食管癌的近期疗效、生存期及毒副反应。方法对48例未接受过任何治疗又不能手术的中晚期食管癌作为研究对象，随机分为放疗加希罗达（治疗组）和单纯放疗（对照组）。对照组放射治疗采用体外三维适形放疗，常规分割，即2Gy／次，5@／wk，GTVDT：60－66Gy左右。治疗组放疗同对照组相同，化疗采用希罗达21d为1周期，d1～d14口服2000mg／d，分2次，1次／12h，po，休息7d，共用2-3周期；第1周期化疗在放疗开始当天起。结果48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91．7％和62．5％，差异有显著的统计学意义（P〈0．05），1a生存率分别为87．5％和75．0％（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。结论口服希罗达增敏联合三维适形放射治疗可提高食管癌的近期疗效，未增加不良反应，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 capecitabine combined with conformal radiation therapy for esophageal cancer. Methods Forty-eight patients were randomly divided into two groups： 24 patients in the treatment group received capecitabine combined with conformal radiation therapy, and the other 24 patients in the control group received only conformal radiation therapy. All patients were treated by conventional fractionated radiotherapy with 60-66 Gy in 30-33 fractions, 2 Gy per fraction, five once a week. The treatment group took 1 000rag capecitabine twice a day for fourteen days followed by a 72day rest period from the first day of radiothcrapy, 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 91.7% and 62.5% respectively with statistically significant differences. The one year survival rate was 87.5% and 75% in the treatment and control groups respectively （P〉0.05）, As for acute radiation esophagitis and myelosuppression, there were no significant differences between the two groups. Conclusions Capecitabine combined with conformal radiation therapy for esophageal cancer can improve the short-term response rate. Its side effects are not statistically different from those of L conformal radiation therapy alone and are tolerable, however its long-term results need further study in the clinic.