紫杉醇每周给药同步调强放疗治疗食管癌

Paclitaxel Chemotherapy and Intensity Modulated Radiation Therapy （IMRT） for Esophageal Carcinoma

目的探讨紫杉醇单药同步调强放疗治疗食管癌的近期疗效、局控率及毒性作用。方法103例食管癌按治疗方法分为2组：放化组（60例），采用调强放疗和紫杉醇治疗；单放组，43例，采用单纯调强放疗治疗。调强放疗系95％PrrV：66GY／30～33次，每周5次，共6周；紫杉醇治疗为放疗第1天紫杉醇60mg静滴，每周1次，共6次。结果病灶近期有效率放化疗组83．3％，单放组60．4％。1、2年生存率，放化组为86．6％、68．3％，单放组分别为55．8％、32．5％。放化疗组与单放组比较差异有显著性（P〈0．05）。毒副反应放化组稍高于单放组，但两组无统计学差异。结论紫杉醇单药每周方案同步调强放疗治疗食管癌近期疗效和局部控制率较好，能提高远期生存率，虽毒性反应略有增加但能耐受。

Objective To evaluate the short - term efficacy,local control rates, survival rates and toxicity of con-current paclitaxel chemotherapy and 1MRT for esophageal carcinoma. Methods 103 cases esophageal carcinoma pa-tients were randomized in two groups ：60 cases were treated with concurrent IMRT and paclitaxel chemotherapy（ named chemo-radiation group）, another 43 cases with radiotherapy only（ named radiotherapy group）. All patients were irra- diated with 2.0 Gy/per fraction by planning target volume （PTV）95%, five fractions a week, the total radiation dose was 66Gy in tumor. Besides,the chemo - radistion group also received the concurrent chemotherapy with 60 mg of pa-clitaxel every Monday when radiation. Results The chemo - radiation group was more effective than radiotherapy group, and there was significant difference between 2 groups （ P 〈 0.05 ）. 1 - year,2 - year survival rates of chemo - radiation group and radiation group were 86.6% ,68.3% and 55.8% ,32.5% ,respectively. Conclusion Concurrent paclitaxel chemotherapy and intensity modulated radiation therapy （IMRT） for esophageal carcinoma can improve the short - term efficacy and local control rate, and hence improve the long - term survival rate with lightly higher and tol-erable toxicity.