复方苦参注射液联合食管癌后程加速超分割放疗的临床观察

Clinical Observation of Compound Sophora flavescens Injection Combined with Late Course Accelerated Hyperfractional Radiotherapy in the Treatment of Esophageal Cancer

目的:观察复方苦参注射液在食管癌后程加速超分割放疗中的减毒作用。方法:将48例食管癌患者随机均分为复方苦参注射液联合后程加速超分割放疗治疗组(A组)和仅用后程加速超分割放疗治疗组(B组)。前2/3程进行常规分割,每次DT1.8～2Gy,每周5次,前后野同中心照射DT40～41.4Gy/20～23次,4～4.6周,后行后程加速超分割放疗,每次1.5Gy,bid,间隔6h,每周5d,总剂量DT65.4～67Gy/38～39次,5.8～6.2周。评价2组近期疗效、生存率、生存质量和毒副作用。结果:A、B组有效率分别为95.8%、79.2%(P>0.05)。A组1、2年生存率为75.0%、58.3%,B组为66.7%、54.2%(P>0.05)。A组KPS评分、放射性食管炎、急性放射性肺损伤与B组比较,均明显改善(P<0.05)。结论:复方苦参注射液联合后程加速超分割放疗能减轻毒副反应,提高治疗耐受性。

OBJECTIVE： To observe the toxic reaction of compound Sophora flavescens injection combined with late course accelerated hyperfractional radiotherapy （LCAF）in treatment of patients. METHODS： A total of 48 cases of esophageal cancer patients were treated by radiotherapy were analyzed. All patients were treated with LCAF, 24 cases treated with compound S. flavescen injection in group A and 24 cases were treated with only LCAF in group B. Former 2/3 for regular division, DT 1.8～2 Gy, 5 times a week, with center illuminate, before and after view,4～4.6 week, and then late course accelerated hyperfractional radiotherapy, 1.5 Gy, bid, 6 h apart, 5 days a week, total dose DT 65.4～67 Gy/38～39, 5.8～6.2 week. The results of laboratory examination, short-term response and toxicity, quality of life were analyzed. RESULTS： The responsive rate in group A and group B were 95.8% and 79.2%, with no significant difference between 2 groups（P0.05）. The 1-year and 2-year survival rates in group A were 75.0% and 58.3%. Those in group B were 66.7% and 54.2%. There was no significant difference between 2 groups（P0.05）. The KPS scores and acute radiation-induced esophagitis were obviously improved in all patients and were better in group A than in group B（P0.05）. CONCLUSION： Compound S. flavescens injection combined with LCAF can reduce toxic reaction, and improve tolerability.