RHEpo联合三维适形放疗对食管癌的近期疗效观察

The clinical effect of RHEpo combined with three dimensional comformal radiotherapy on esophageal neoplasms

目的观察RHEpo联合三维适形放疗对Ⅲ期食管癌的近期疗效及毒副反应。方法将62例欲接受根治性放疗的Ⅲ期食管癌患者随机分为试验组和对照组。试验组:在放疗前1周给予RHEpo3万U,皮下注射,每周1次,至放疗结束。放疗用6MVX射线进行三维适形照射,DT1.8～2.0Gy/次,每周5次,中位剂量为DT64Gy。对照组行单纯三维适形照射,照射野和剂量同试验组,中位剂量为DT65Gy。结果放疗DT20Gy时,试验组完全消退率(CRR)6.7%(2/30),对照组CRR6.7%(2/30)(χ2=0.2679,P=0.6048);放疗DT40Gy时,试验组CRR33.3%(10/30),对照组CRR16.7%(5/30)(χ2=2.2222,P=0.1360);放疗结束时,试验组CRR50.0%(15/30),对照组CRR26.7%(8/30)(χ2=3.4548,P=0.0631);放疗后1个月,试验组CRR63.3%(19/30),对照组CRR36.7%(11/30)(χ2=4.2667,P=0.0389);放疗后6个月,试验组CRR66.7%(20/30),对照组CRR40.0%(12/30)(χ2=4.2857,P=0.0384)。两组在血液学毒性方面有统计学差异(χ2=8.1481,P=0.0043)。结论RHEpo联合三维适形放疗能明显提高Ⅲ期食管癌的近期疗效,血液学毒性轻微,并可预见能延长患者的远期生存,值得临床上试用推广。

Objective To observe the clinical effect and side effect of recombined human erythropoietin （RHEpo） combined with three dimensional comformal radiotherapy on esophageal neoplasms with stage Ⅲ.Methods From March 2003 to May 2007,62 patients diagnosed esophageal neoplasms with stage Ⅲ were randomly divided into the trial group or the control group.In the trial group,RHEpo was administered at 30 000U weekly during the course of three dimensional conformal radiotherapy and one week before radiation.The control group was only given three dimensional conformal radiotherapy.Radiation was administered with 6MV X-rays,1.8～2.0Gy per day and 5 times per week.Total dose was 60～70Gy over 6～7 weeks,and the median doses were 64Gy and 65Gy respectively.Results At the end of DT 20Gy,complete remission rate （CRR） in both groups were 6.7% （2/31） （χ2=0.2679,P=0.6048）,while DT 40Gy was over,the CRR was 33.3% （10/30） and 16.7%（5/30） （χ2= 2.2222,P=0.1360） respectively,when the whole radiotherapy was finished,the CRR was 50.0% （15/30） and 26.7% （8/30） （χ2= 3.4548,P=0.0631） respectively,and one month and six months after radiotherapy,the CRR were 63.3% （19/30） and 66.7% （20/30） in the trial group,and 36.7% （11/30） and 40.0% （12/30） in the control group respectively （χ2=4.2667,P=0.0389;χ2=4.2857,P=0.0384）.The rates of acute hematological toxicity were different in two groups （χ2=8.1481,P=0.0043）.Conclusion RHEpo combined with three dimensional comformal radiotherapy can improve the clinical effect of patients diagnosed esophageal neoplasms with stage Ⅲ,and its hematological toxicity was light.Further more,it may elongate life time of these patients.