食管癌同期放化疗TP方案周疗与三周疗法对照研究

Weekly TP regimen versus tri-weekly TP regimen therapy in concurrent chemoradiotherapy for esophageal cancer

目的探讨中晚期食管癌同步放化疗TP方案周疗与3周疗法的近期疗效及毒副反应。方法56例中晚期食管癌患者，进行前瞻性数字法随机分成周方案组和3周方案组各28例。两组均采用三维适形调强放疗，总剂量59．4Gy。周方案组：紫杉醇40mg／m2，顺铂25mg／m2，1次／周，连用6周；3周方案组：紫杉醇135mg／m。，第1天，颇铂25mg／m2，第2—4天。21天为1个周期，共2周期。治疗结束后评价两组疗效。结果近期疗效：周方案组和3用方案组病情缓解率（CR＋PR）分别是89．3％和96％，差异无显著性（P〉0．05）。毒副作用：3周方案组消化道反应、白细胞减少、神经毒性均高于周方案组，差异有统计学意义（P〈O．01或P〈0．05）。结论食管癌同步放化疗TP方案周疗与传统3周疗法近期疗效相当，但毒副反应明显降低。远期疗效有待进一步观察。

Objective To contrast short-term efficacy and toxicity in concurrent chemoradiotherapy for advanced e- sophageal cancer with weekly TP regimen and Tri-weekly TP regimen therapy. Methods 56 patients with advanced e- sophageal cancer were randomly assigned into either the first group accepted weekly TP regimen （28cases） or the second group accepted tri-weekly TP regimen therapy （28cases） and the data were analyzed using software SPSS 17. Both groups accepted Intensity modulated radiation therapy （IMRT） ~ the total dose of IMRT was 59. 4 Gy. The Former group was treated with paclitaxel 40mg/m2 and cisplatin 25mg/m2 once per week, and the treatment lasted for 6 weeks. The latter group was treated with paclitaxel 135 mg/m2, dl, and cisplatin 25mg/m2, d2.3.4, the treatment was recycled ev- ery 21days and last for 2 cycles. Results For short - term efficacy, remission rate （CR＋PR） of the first group and the second group were 89.3~ and 96~, there was no significant statistic difference （P〉0.05）. For toxicity, gastrointesti- nal reactions, leucopenia and neurotoxicity of the second group were apparently higher than the first group; the P value was 0. 01, 0.03, 0 for gastrointestinal reactions leucopenia and neurotoxicity, there was significant statistic difference. Conclusion There is no significant difference in short-term efficacy between weekly TP regimen and triweekly TP regi- men therapy in concurrent chemoradiotherapy for advanced esophageal？ cancer, weekly TP regimen has a significantly lower toxicity. The long-term efficacy remains to be seen.