多西他赛和顺铂联合同步放疗治疗中晚期贲门癌

Clinical Observation on Radiotherapy Combined with Synchronous Chemotherapy with Docetaxel and Cisplatin for Advanced Cardia Cancer

目的观察多西他赛联合顺铂同步放化疗治疗晚期贲门癌的疗效。方法将73例中晚期贲门癌患者随机分为两组,放化疗同步组32例采用2Gy/次,共60Gy/6周,同时以多西他赛120mg/d静脉滴注d1,顺铂30mg/d静脉滴注d2～4,每3周一周期方案连续化疗4周期。结果同步放化疗组和单纯放疗组CR分别为6.3%、0(χ2=1.354,P=0.245),两组PR分别为78.1%3、1.7%(χ2=44.721,P=0.000),同步放化疗不良反应发生率高于单纯放疗组,其中主要为Ⅱ度白细胞计数降低,发生率分别为43.8%、0(P<0.05),Ⅰ～Ⅱ度周围神经炎发生率分别为9.4%0、(P<0.05),经对症处理后患者均耐受良好。结论多西他赛联合顺铂同步放化疗治疗中晚期贲门癌是较单纯放疗疗效好、不良反应较轻的治疗方法,值得进一步研究,甚至临床推广。

Objective To observe the efficacy and adverse affects of radiotherapy combined with synchronous chemotherapy using Docetaxel and Cisplatin for advanced cardia cancer.Methods Divide all the patients with advanced cardia cancer into two groups,the patients in the treatment group 32 cases received the treatment of 6000cGy radiotherapy for 6 weeks and 4 cycles of synchronous chem-otherapy with Docetaxel 120mg（in the first day） and Cisplatin 30mg（in the day 2 to 4） in 21 days.The control group 41 cases were received the treatment of 6000cGy radiotherapy for 6 weeks.The efficacy and adverse affects were analyzed after four weeks of the treatment.Results The CR of the two groups was 6.3% 、0% respectively（χ^2 =1.354,P = 0.245）,but the PR of the group with radiotherapy and synchronous chemotherapy was significantly higher than the control group（78.1% vs 31.7%,χ^2 =44.721,P = 0.000）.The adverse effect of the treatment group was more serious than control group,especially,the incidence of gradeⅡdepress of WBC was 43.8% 、0% respectively（P 〈 0.05）,moreover,The incidence of the reversible gradeⅠ ～ Ⅱneurosensory toxicity was 9.4% 、 0% respectively（P 〈 0.05）.Conclusion Radiation combined with synchronous chemotherapy with Docetaxel and Cisplatin show good efficacy and tolerable toxicity in treatment of patients with advanced cardia cancer.