三维适形放疗联合多西紫杉醇同期化疗治疗84例老年食管癌

Clinical Study of Three-dimensional Conformal Radiotherapy Combined with Docetaxol in 84 Older Patients with Unresectable Esophageal Carcinoma

目的:探讨三维适形放射治疗联合多西紫杉醇同期化疗治疗老年食管癌的疗效和毒副作用。方法:84例老年食管癌患者随机分成A组和B组,A组40例采用三维适形放射治疗,总剂量50Gy～64Gy/25次～32次,5周～7周完成。B组44例采用三维适形放射治疗联合多西紫杉醇25mg/m^2/周同期化疗。结果:两组患者的无进展生存期分别为9.52个月和12.00个月(P=0.036)。两组2年总生存期分别17.75个月和20.42个月(P<0.05)。两组患者毒副反应主要为放射性食管炎和骨髓抑制,后期放射副反应主要为放射性肺炎,但两组发生率差异无统计学意义(P>0.05)。结论:三维适形放射治疗联合多西紫杉醇同期化疗治疗老年食管癌疗效优于单纯三维适形放射治疗,毒副反应可耐受。

Objective： To evaluate the therapeutic efficacy and the complication of three-dimensional conformal radiotherapy （3DCRT） combined with Docetaxol in older patients with unresectable esophageal carcinoma. Methods： Eighty-four older patients with unresectable esophageal carcinoma were randomly divided into two groups. The 40 patients in group A received 3DCRT and the total dose was 50 Gy to 64 Gy in 25 to 32 fractions which was completed in 5 to 7 weeks. The 44 patents in group B received the same 3DCRT regimen combined Docetaxol 25mg（ m2. w）- 1. Results： The two-year progression-free survival in group A and B were 9. 52 months and 12.00 months （ p = 0. 036） and the two-year overall survival were 17.75 months and 20. 42 months, respectively （ P = 0. 022）. The major complication observed in the two groups were radiation esophagitis and hematopoietic toxicity. The later radiation complication in the two groups was radiation lung fibrosis, hut significant difference was not observed （ P 〉 0. 05 ）. Conclusion： The efficacy of 3DCRT combined with Docetaxol is better than 3DCRT alone in older patients with unresectable esophageal carcinoma. The complications are acceptable.