卡培他滨化疗联合三维适形放疗治疗食管癌近期疗效观察

Three dimensional-conformal radiotherapy combined with capecitabine for patients with esophageal cancer

目的探讨卡培他滨化疗联合三维适形放疗治疗食管癌的疗效及毒性反应。方法选择71例符合入组标准的食管癌患者,随机分为两组,同步放化疗组(放化组)36例:采用6MV-X线,应用三维适形放疗方法照射至总剂量为60～70Gy/(6～7)w,常规分割每周5次,每次2Gy。放疗开始第1d给予卡培他滨1 000mg/m2,每日口服2次,餐后30min服用,连用2周后,停用1周,21d为1个周期,服用2周期。单纯放疗组(单放组)35例,放疗方法同放化组。结果放化组与单放组有效率分别为88.9%、68.6%(P<0.05)。放化组的骨髓抑制、胃肠道反应、放射性食管炎等毒副反应发生率大于单放组,但两组差异无统计学意义(P>0.05),且患者均能耐受。结论卡培他滨化疗联合三维适形放疗治疗中晚期食管癌近期疗效较单纯应用三维适形放疗疗效明显。

Objective To evaluate the therapeutic effection, toxicity of concurrent chemotherapy（capecitabine）and three dimensional-conformal radiotherapy（3D-CRT） for patients with advanced esophageal cancer. Methods 71 patients with esophageal cancer were randomly divided into two groups： 35 cases received 3DCRT alone. Radiation therapy using 6MV - X-ray, three-dimensional conformal radiotherapy method for total dose radiation to 60 -70Gy / 6 to 7 weeks, conventional segmentation 2Gy,5 times per week. 36 cases received 3D - CRT combined with capecitabine , Capecitabine was given in first day of radiotherapy, l000 mg/（m2·d）, for 2 weeks,rest 1 week,21 days a cycle,taking two cycles.Results The overall response （CR ＋ PR） rates for the radiotherapy combined with Capecitabine group and the radiotherapy alone group were 88.9% , 68.6%（ P 〈0. 05） respectively. The acute toxicities reaction was severer in radiotherapy combined with chemotherapy group but they were accepted. Conclusion： Three dimensional-conformal radiotherapy combined with Capecitabine for patients with advanced esophageal cancer could significantly improve the local control rate and had slight side effect.