多西他赛和奈达铂同步或序贯放射治疗中晚期食管癌的对比研究

Contrastive study on concurrent chemoradiotherapy and sequential chemoradiotherapy with docetaxel and nadaplatin for local advanced esophageal cancer

目的:评价多西他赛和奈达铂同步放化疗与序贯放化疗治疗中晚期食管癌的疗效和毒副作用。方法:89例中晚期食管癌患者随机分成两组:观察组(同步放化疗)45例,放疗同时行多西他赛和奈达铂方案化疗2个周期;对照组(序贯放化疗)44例,先单纯行放疗,放疗结束后序贯多西他赛和奈达铂方案化疗2个周期。放疗均采用直线加速器(6MV X射线)调强适形放疗(IMRT),放疗剂量达(60～64)Gy/(30～32)次。结果:观察组近期有效率为88.9%,明显高于对照组的70.5%,差异有统计学意义,P<0.05。1、2年生存率观察组为84.4%和68.9%,明显高于对照组的65.9%和45.5%,差异有统计学意义,P<0.05。观察组恶心、呕吐及急性白细胞下降发生率高于对照组(P<0.05),但可以耐受。其他毒副作用差异无统计学意义,P>0.05。结论:多西他赛和奈达铂同步放化疗治疗中晚期食管癌,能提高近期疗效及1、2年生存率。急性毒副作用略增加,但可以耐受。

OBJECTIVE：To evaluate the clinical curative effect and toxicity of concurrent versus sequential chemora- diotherapy with docetaxel and nadaplatin for local advanced esophageal cancer. METHODS： Eighty-nine patients with local advanced esophageal cancer were randomly divided into the study group （n=45） and the control group （n=44）. The stud- y group received radiotherapy concurrent with two cycles of chemotherapy with docetaxel and nadaplatin. The control group received radiotherapy first only,then received two cycles of sequential chemotherapy with docetaxel and nadaplatin. All patients received IMRT using 6 MV X-ray, and the total doses were （60-64） Gy/（30-32） f. RESULTS： The re- sponse rate was highter in the study group （88. 9 %） than that the control group （70. 5 %）, and there was significant difference between two groups （P〈0.05）. The 1-and 2-year survival rates for the patients were 84.4% and 68.9M in the study group and 65.9 % and 45.50% in the control group,respectively. There were significant difference （P〈0.05）. More nausea and vomiting occurred in the study group than the control group （P〈0.05）. The incidence of acute hone marrow inhibition was higher in the study group than the control group （P〈0.05）, but they could be tolerated. Other toxicities had no significant difference between the two groups （P〈0.05）. CONCLUSIONS： Docetaxel and nadaplatin concurrent chemoradiotherapy in local advanced esophageal cancer can obviously improve the short-term effect and the 1-and 2-year survival rate of the patients. The acute toxicity of patients is slight increase but can be tolerated.