替吉奥联合三维适形放射治疗消化道恶性肿瘤腹膜后淋巴结转移

TS-1 combined with three-dimensional conformal radiotherapy(3DCRT) for treatment of retroperitoneal lymph node metastases of digestive tract malignant tumors

目的观察替吉奥联合三维适形放疗治疗消化道恶性肿瘤腹膜后淋巴结转移的近期疗效。方法 50例消化道恶性肿瘤腹膜后淋巴结转移患者随机分为两组：单纯三维适形放疗组（对照组）25例,三维适形放疗联合替吉奥组（替吉奥组）25例。三维适形放疗分割剂量为2 Gy次/,5次/周,总剂量54~60 Gy。替吉奥组自放疗开始之日起口服替吉奥[80 mg/（m2.d）],每日分2次口服,d1~14。间隔1周后再次使用替吉奥14 d。结果替吉奥组CR率为56.0%,PR率为36.0%,总有效率为92.0%。对照组CR率为32.0%,PR率为40.0%,总有效率为72.0%。两组疗效比较差异有显著性（Z=-2.145,P=0.032）。两组毒副反应比较差异有显著性,但经过临床处理可以得到控制。结论替吉奥联合三维适形放疗治疗恶性肿瘤腹膜后淋巴结转移是一种安全有效的治疗方法。

Objective To evaluate the efficacy of TS-1 combined with three-dimensional conformal radiotherapy（3DCRT） in treatment of retroperitoneal lymph node metastases of digestive tract malignant tumors.Methods Fifty patients with retroperitoneal lymph node metastasis of digestive tract malignant tumors were divided randomly into two groups：3-dimensional conformal radiotherapy group（3D-CRT group,25cases）and chemoradiotherapy group（TS-1 group,25cases）.Both groups received 3DCRT.The total dose of 3DCRT was 54-60 Gy（2-3 Gy/f,5 f/w）.TS-1 group received two cycles of TS-1 treatment at dosage of 80 mg/（m2·day） and administration for 2 weeks,followed by a 1-week rest.Results In the patients of TS-1 group,the rates of complete response,partial response and total response were 56.0%,36.0%,92.0%,respectively.In the patients of 3D-CRT group,they were 32.0%,40.0%,72.0%,respectively.There was significant difference between TS-1 group and 3D-CRT group（Z=-2.145,P=0.032）.The side effects could be solved in the two groups.Conclusion TS-1 combined with three-dimensional conformal radiotherapy（3DCRT） is effective and safe for patients with retroperitoneal lymph node metastasis.