新疆哈萨克族与汉族晚期食管癌同期化放疗疗效比较

The short-and log-term effects and side effect comparisons of concurrent chemoradiotherapy in the treatment for kazak and han nationality patients with advanced esophageal carcinoma in Xinjiang provenience

目的比较三维适形放疗（3DCRT）同期DF方案（顺铂加氟尿嘧啶）化疗治疗新疆哈萨克族和汉族中晚期食管癌的近远期疗效及不良反应差异。方法112例中晚期食管癌患者中汉族68例，哈萨克族44例。化疗方案为氟尿嘧啶1000mg/m2连续24h静脉滴注加顺铂20mg／m2第1～4天静脉滴注，21d为1个周期，共4～6个周期。3DCRT从化疗第1天开始，常规分割，D，60—66Gy分30—33次6～7周完成。结果随访率为100％，哈萨克族和汉族随访满2年者分别为23、27例。哈萨克族和汉族的有效率分别为77％和85％（x2=4．89，P=0．180），1、2年生存率分别为75％和59％、52％和40％（x2=1．71，P=0．191）。哈萨克族和汉族3～4级急性放射性食管炎发生率分别为5％和7％（x2=1．66，P=0．435），3—4级急性放射性肺炎发生率分别为2％和1％（x2=0．99，P=0．608），3—4级血液学反应发生率分别为9％和29％（x2=6．57，P=0．037）。结论3DCRT同期DF方案化疗治疗新疆哈萨克族和汉族中晚期食管癌患者的近远期疗效相似，血液学不良反应不同，哈萨克族患者耐受性较好。

Objective To study the short-term curative effects and side effects of the threedimensional conformal radiotherapy combined with chemotherapy in advanced esophageal cancer in Xinjiang provenience. Methods One hundred and twelve cases were divided into Kazak and Han nationality group according to the different nations. Chemotherapy was DF regime ：5-Fu 1000 mg/m2 ＋ DDP 20 mg/m2, d1-4, 21 days as a cycle, total 4 -6 cycles. For both groups, 3DCRT was carried out by conventional fractionation with total dose of 60 - 66 Gy/30 - 33frin 6 - 7w. Results The following-up rate was 100%. The number of patients followed up at two years were 23 and 27 in Kazak and Han nationality group, respectively. The immediate effective rates （CR （complete remission） ＋ PR （partial remission）） were 77% （34/44） and 85% （58/68） in han and kazak group, respectively （X2 = 4. 89,P = 0. 180）. The 1-and 2-year survival rate were 75% , 59% and 52% , 40% （X2 = 1.71 ,P = 0. 191 ） in Kazak and Han group, respectively. The 3 - 4 grade radioesophagitis were 5% （2/44） arid 7 % （5/68） in kazak group and han group, respectively （X2 = 1.66,P =0. 435）. The 3 -4 grade radiopneumonia were 2% （1/44） and 1% （ 1/68 ） in kazak group and han group, respectively （X2 = 0. 99, P = 0. 608）. The 3 -4 grade haematological toxicity were9% （4/44） and 29% （20/68 in kazak and in han group, respectively （ X2 = 6. 57, P = 0. 037）. Conclusions There was no significant difference in short-term curative effects between patients from han and kazak nationality with advanced carcinoma of esophagus who received the three-dimensional conformal radiotherapy combined with chemotherapy, but Kazak people showed better tolerance.