周剂量奈达铂联合三维适形放疗治疗食管癌的近期疗效观察

Analysis of three-dimensional conformal radiation therapy with concomitant weekly nedaplatin for patients with esophageal carcinoma

目的探讨每周剂量奈达铂联合三维适形放射治疗同步治疗食管癌的临床疗效和安全性。方法将58例食管癌患者随机分为2个组,两组均采用三维适形放疗,常规分割放疗,总剂量64-70 Gy,6-7周完成。奈达铂组（31例）放疗期间每周给予奈达铂30 mg/m2一次,连续6-7周;顺铂组（27例）每周给予顺铂30 mg/m2一次,连续6-7周。结果奈达铂组和顺铂组的CR、PR、NR百分比分别为35.5%、51.6%、12.9%和25.9%、44.4%、29.6%;奈达铂组和顺铂组的1年局部控制率分别为64.5%和51.9%;奈达铂组和顺铂组的1年生存率分别为54.8%和48.1%。以上两组差异均无统计学意义（P〉0.05）。与顺铂组对比,奈达铂组的恶心呕吐反应较轻,差异有统计学意义（P〈0.05）;奈达铂组的白细胞减少和血小板减少发生率较顺铂组稍高,差异均无统计学意义（P〉0.05）。结论三维适形放疗联合周剂量奈达铂同步治疗食管癌有较好的近期疗效和局部控制率,患者更易耐受,值得临床推广应用和研究。

Objective To evaluate the efficacy of three-dimensional conformal radiation combined with weekly nedaplatin for the patients with esophageal carcinoma. Methods Fifty-eight patients with esophageal carcinoma were divided into two groups： the trial group（31 patients） and the control group（27 patients）.All patients were received 64-70Gy in 32-35 fractions using three-dimensional conformal radiation.The trial group was received chemotherapy with weekly nedaplatin,and the control group was received chemotherapy with weekly cisplatin.Nedaplatin（30mg/m2） and cisplatin（30mg/m2） were administered once a week.Results The complete response rates（CR） and particle response（PR） rates of the trial group and the control group 35.5%,51.6% and 25.9%,44.4%,respectively（P0.05）.The local control rates at one years were 64.5% and 51.9%,respectively（P0.05）.The one year surviva1 rates were 54.8% and 48.1% in the trial group and the control group,respectively（P0.05）.The occurrence rate of gastrointestinal reaction was lower in trial group than in control group.The occurrence rates of neutropenia and thrombocytopenia were higher in the trial group than in the control group.Conclusions Three-dimensional conformal radiation combined with weekly nedaplatin can effectively treat advanced esophageal cancer.It has a good clinical tolerance.