马蔺子素在食管癌放疗中增敏作用的临床研究

A clinical study of radiosensitizing effect of irrisquinone combined with radiotherapy in esophageal cancer

目的 观察马蔺子素对食管癌放疗的增敏作用及毒副反应。方法 １９９６ 年１ 月至１９９７ 年８ 月，将６０ 例胸中段髓质型食管鳞癌病人随机分为试验组和对照组。试验组：在放疗的同时口服马蔺子素胶囊２ 次／ 日，１１０ｍｇ／ 次，直到放疗结束。放疗用６０Ｃｏ 或６ＭＶ或１５ＭＶＸ 射线为放射源，５ 次／周，ＤＴ２ Ｇｙ／ 次，前后两野对穿照射ＤＴ４０ Ｇｙ 后，再两野成角照射ＤＴ２０ ～３０Ｇｙ，中位剂量为ＤＴ６６－１ Ｇｙ。对照组单纯放疗，其设野和剂量分别同试验组，中位剂量为ＤＴ６８－６ Ｇｙ。结果 放疗结束时，试验组完全消退率（ＣＲ） 为５３－３３％ ，对照组ＣＲ 为２６－６７％ ，Ｐ＜ ０－０５ ；放疗后３ 个月ＣＲ分别为７３－３３ ％ 和４６－６７％ ，依据４０ Ｇｙ及６０ Ｇｙ时病变消退情况计算的增敏比分别为１－６８ 和１－２７。试验组出现的临床反应主要为恶心、呕吐和腹泻，发生率为５６－６％ ，高于对照组的３０ ％ ，但病人均可耐受。结论 马蔺子素对食管癌有明显的放射增敏作用，毒副作用轻微，值得临床上进一步推广应用。

Objective To observe the radiosensitization and side effects of irrisquinones in combination with radiotherapy in treatment of esophageal cancer. Methods From January 1996 to August 1997,60 cases of esophageal cancer were randomly divided into two groups——the trial group (irisquinone plus irradiation,30 cases) and the control group(radiotherapy alone,30 cases).In the trial group,irisquinone provided by Shangdong Xinhua Pharmaceutical Factory was administered at 220mg/m 2/day (110mg/m 2,twice daily),in combination with radiotherapy throughout the course of treatment.Irradiation was administered with 1.25 MeV 60 Co γ rays and /or 6MV or 15MV X rays,2 Gy per day and 5 times per week.Total dose was about 60 70 Gy over 6 7 weeks,and the median doses to the trial group and the control group were 66.1 Gy and 68.6 Gy,respectively. Results At the end of treatment course,complete remission rate(CR) in the trial group was 53.33% whereas that in the control group was 26.67% ( P < 0.05), and three months later,the CR were 73.33% and 46.67%,respectively.Sensitization ratios of irrisquinones were 1.68 and 1.27 by the the partial remission at doses of 40 Gy and 60 Gy.The acute toxicity of irrisquinones were diarrhea,nausea and vomiting.The diarrhea rate was 56.6% in the trial group which was higher than that in the control group,but it was generally not severe and the patients were adapted to it soon without interruption of its administration. Conclusion Irrisquinones in combination with radiotherapy in treatment of esophageal cancer can increase the complete remission rate at the end of treatment course.