替吉奥与奈达铂加同步放疗治疗中晚期食管癌临床观察

S-1 plus nedaplatin and combined with concurrent radiotherapy in the treatment of medium and terminal esophageal cancer

目的探讨替吉奥+奈达铂(S1N)、5-氟尿嘧啶+顺铂(FP)方案加同步放疗治疗中晚期食管癌的疗效,毒副反应及耐受性观察。方法 62例中晚期食管癌患者随机分为两组:试验组(S1N方案加同步放疗)30例,对照组(FP方案加同步放疗)32例。放疗均采用钴60-γ线常规分割照射。结果 S1N化放组、FP化放组有效率分别为86.7%、62.5%。S1N化放组的有效率高,差异有统计学意义(P<0.05)。S1N化放组、FP化放组1年生存率分别为73.3%、59.4%,差异无统计学意义(P>0.05)。主要副反应为消化道反应、骨髓抑制,放射性食管炎。FP组消化道反应、静脉炎较重,比较差异有统计学意义(P<0.05)。S1N组骨髓抑制较重,差异无统计学意义(P>0.05)。患者可以耐受,无治疗相关性死亡。结论两方案同步放化疗治疗均可用于中晚期食管癌的综合治疗。

Objective To evaluate the efficacy and safety of S-1 plus nedaplatin and combined with concurrent radiotherapy in the treatment of terminal esophageal cancer. Methods From June 2009 to December 2011, 62 patients with advanced squamous cell carcinoma of the esophagus were divided into two groups of the experimental group （30 cases） and the control group （32 cases）. Radiotherapy was used cobalt 60- γ-line conventional fractionated irradiation. Results The overall response rate （CR＋PR） of the experimental group and the control group were 86.7% and 62.5% respectively （P 〈 0.05）.The year survival rates of SIN chemoradiotherapy group and FP chemoradiotherapy group were 73.3% and 59.4%, the difference was not statistically significant （P 〉 0.05）. The main toxicities were nausea, vomting, marrow depression and radioactive esophagitis. The control group patients had more toxicities. All of them complete treating plan. Conclusion The short term curative effect of S-1 and nedaplatin in combination with radiotherapy is feasible for medium term and terminal esophageal cancer, and toxicity is tolerable.