不同剂量TP方案化疗联合同步放疗治疗局部晚期食管癌的疗效观察

Different doses of TP regimen combined and concurrent radiotherapy to the treatment of locally advanced esophageal cancer

目的探讨不同剂量TP方案化疗联合同步放疗治疗局部晚期食管癌疗效及毒副反应。方法 53例局部晚期食管癌患者分成三组：大剂量紫杉醇＋顺铂联合放疗组（以下简称大剂量组：DDP100mg／m2，dl；PTX175mg／m2，d1）18例；小剂量紫杉醇＋顺铂联合放疗组（以下简称小剂量组：DDP20mg／m2，dl-5；PTX20mg／m2，dl、3、5）16例；单纯放疗组19例。化疗21天为1个周期；放疗采用三维适形放疗，常规分割，总剂量60Gy／6W。结果大剂量组、小剂量组、单纯放疗组完全缓解（CR）率、有效率（CR＋PR）及1年生存率分别为58．8％、81．3％、26．3％；88．2％、93．8％、57．9％及94．1％、100％、73．7％。三组比较，大、小剂量组CR率、CR＋PR率均较单纯放疗组有统计学差异，P〈0．05；小剂量组与单纯放疗组在1年生存率上差异有统计学意义，P〈0．05。毒副反应大剂量组在骨髓抑制、胃肠道反应、脱发，较小剂量组、单纯放疗组差异有统计学意义，P〈0．05。结论小剂量TP方案化疗联合同步放疗治疗局部晚期食管癌，疗效较好，毒副反应可以耐受。

Objective To investigate different dose of TP regimen of concurrent radiotherapy and chemotherapy combined treatment of locally advanced esophageal cancer efficacy and toxicity. Methods 53 patients with locally advanced esophageal cancer patients were divided into three groups ： High doses of paclitaxel plus cisplatin in combination with radiotherapy group（ hereinafter referred to as the high dose group：the DDP 100 mg/m2 dl ;PTX175 mg/m2, dl ）18 cases; Low doses of paclitaxel plus cisplatin combination with radiotherapy group （hereinafter referred to as Low doses Group：DDP 20 mg/m2 dl -5 ;of PTX 20 mg/m2 dl ,3,5 ）16 cases; 19 cases of the radiotherapy alone group. Chemotherapy 21 days for a cycle;Radiotherapy using three - dimensional eonformal radiotherapy, conventional fractionation, total dose 60 Gy/6 W. Results The high - dose group, low - ose group, radiotherapy group, complete remission （ CR ） rate, response rate （ CR ＋ PR ） and 1 - year survival rates were 58.8%,81.3%,26.3%;88.2%,93.8%,57.9 % and 94. 1%,100%,73.7%,respectirely. Three groups,high and low dose group, CR rate, CR ＋ PR rate than radiotherapy alone group were significantly different （ P 〈 0.05 ） ; low - dose group and radiotherapy group in the 1 - year survival difference was statistically significant, P 〈 0.05. The toxicity of high - dose group in the bone marrow suppression, gastrointestinal reactions, hair loss, the lower dose group and radiotherapy group difference was statistically significant （ P 〈 0.05 ）. Conclusion Small doses of TP chemotherapy with concurrent radiotherapy and the treatment of locally advanced esophageal cancer hare better efficacy,and its toxicity can be tolerated.