放疗联合周剂量奈达铂治疗老年食管癌的临床研究

Clinical Observation of Weekly-dose Nedaplatin Combined with Radiation or Elderly Patients with Esophageal Carcinoma

目的探讨放疗联合周剂量奈达铂治疗老年食管鳞癌患者的疗效及毒性。方法选取49例老年食管癌患者,随机分成奈达铂每周化疗同步放疗(同步组)24例和单纯放射治疗(单放组)25例,两组放疗均采用常规分割,照射剂量60～66Gy。同步组奈达铂30mg/m2,每周1次,连续6周。结果同步组完全缓解10例,部分缓解11例,有效率87.5%,单放组完全缓解4例,部分缓解11例,有效率60.0%,两组比较差异有统计学意义(P<0.05)。同步组2～3度白细胞下降54.2%,明显高于单放组的20.0%(P<0.05),同步组3度血小板下降3例,单放组无3度血小板下降病例。两组2～3度放射性食管炎发生率差异无统计学意义(37.5%,32.0%)。结论奈达铂每周化疗同步放疗治疗老年食管癌近期疗效较好,骨髓抑制加重但可耐受。

Objective To evaluate the efficacy and the toxicity of weekly-dose Nedaplatin combined with radiation for esophageal squamous cell carcinoma in elderly patients. Methods 49 patiens were randomly divided into two groups to receive either radiotherapy only（Danfang group, 25 cases） or weekly dose nedaplatin combined with radiotherapy（Tongbu group, 24 cases）. Patiens in both groups received conventional radiotherapy with a total dose of 60-66Gy. In Tongbu group, Nedaplatin was administered 30mg/m2 from the first day of radiotherapy, once a week, for 6 successive weeks. Results Among 24 patients in the Tongbu group,10 achieved CR（41.7%）, 11 PR（45.8%）, and respond rate（CR plus PR） was 87.5%, compared with Danfang group, 4 achieved CR（16.0%）, 1 l PR（44.0%）, and respond rate（CR plus PR） was 60.0%, respectively（P〈0.05）. The occurrence rate of G2/3 toxicity of leukopenia in Tongbu group was 54.2%, obviously higher than the Danfang groups （P〈0.05）. The occurrence rates of G2/3 toxicity of radiation esophagitis between two groups had not statistical differences. Conclusion Weekly-dose Nedaplatin combined with radiotherapy can effectively treated esophageal cancer in elderly patients.