联合希罗达同步放化疗治疗胃癌疗效观察

The study of radiotherapy combining chemotherapy with xeloda in-synchronism for gastric cancer

目的探讨三维适形放疗联合希罗达治疗未手术胃癌的临床效果及毒副反应。方法回顾性分析我院2006年6月～2008年6月使用三维适形放疗联合希罗达治疗未手术胃癌患者32例,放射治疗每周5次,每天1次,单次剂量2Gy,总剂量42Gy,局部缩野加量至56Gy。同步口服希罗达每周5次,每日1000mg/m2。结果29例按计划完成了治疗,总有效率为76%,1年总生存率为72%。消化道反应是最常见的毒性反应,3级反应5例(15.6%),未见明显4级反应。结论三维适形放疗联合希罗达治疗不能手术胃癌是有效的治疗方法,局部控制率好,毒副反应能够耐受,但远处转移的控制有待更进一步研究。

Objective To approach the clinical effect and toxicity of three-dimensional conformal radiotherapy（3D CRT）combining chemotherapy with xeloda in-synchronism for the patients inoperable with gastric cancer.Methods 32 patients with gastric cancer inoperable but no metastasis,who were treated with 3D CRT and combining chemotherapy with xeloda in-synchronism between June 2006 and June 2008,were retrospectively analyzed.At first,the plan of radiotherapy was administered with fraction delivery 2Gy/day for 5 days/week up to a total dosage of 42 Gy,then reduced field boost the dosage to 56Gy.In-synchronism,oral Chemotherapy with xeloda 5 times a week,daily 1000mg/m2.Results Chemoradiotherapy was completed on 29 patients.The overall response rate was 76%.The 1-year survival rate was 72%.Gastrointestinal reactions were the most common toxicity,1 grade for 5 people（15.6%） and no reaction to 4 grade obviously.Conclusion 3D CRT combining chemotherapy with xeloda in-synchronism for the patients with gastric cancer is one of the safe and effective treatments with good local control rate and tolerated toxicity.The long term complications need to be further studied.