周剂量奈达铂同步三维适形放射治疗局部中晚期食管癌的疗效观察

Weekly dose nedaplatin combined with conformal radiotherapy for advanced esophageal cancer

目的:探讨周剂量奈达铂化疗同步放射治疗局部中晚期食管癌的疗效及不良反应。方法:90例局部中晚期食管癌患者,随机分为奈达铂同步放疗组(R+C组)和单纯适形放疗组(R组)。R组患者仅接受适形放疗,总量(60-70)Gy/(6-7)w,R+C组患者在放疗的基础上加用奈达铂,每周30mg/m2一次,连续6-7周。观察两组患者的近期疗效、远期疗效和不良反应。结果:R+C组完全缓解率(CR)55.6%,R组CR33.3%,两组比较差异有统计学意义(P<0.05)。1年、2年、3年生存率R+C组分别为77.8%(35/45)、44.4%(20/45)、37.8%(17/45),R组分别为66.7%(30/45)、31.1%(14/45)、22.2%(10/45),两组比较差异无统计学意义(P>0.05)。放化组发生急性消化道反应、白细胞减少和血小板减少,稍高于单放组,多数为I-II级。结论:周剂量奈达铂同步放射治疗局部中晚期食管癌有较好的疗效,不良反应小,易耐受,方便门诊治疗,值得临床推广应用。

Objective：To evaluate the effect and adverse reaction of weekly dose nedaplatin（NDP） combined with three-dimensional conformal radiotherapy （3D-CRT） in the treatment of local advanced esophageal carcinoma.Methods：A total of 90 patients with local advanced esophageal cancer were divided into two groups randomly,one group （R ＋ C group） was treated by weekly dose NDP [30mg/（m2 · w）,a total of 6-7 weeks] and 3 D-CRT （a total dose of 60-70Gy/6-7w）,and the other group （R group） was treated only by 3D-CRT （a total dose of 60-70Gy/6-7w）.Then,the near and long-term treatment effects,as well as the adverse reaction were observed.Results：The complete response rate（CR） of R ＋ C group was 55.6％,the other group （R group） was 33.3％ （P ＜0.05）.The 1-,2-,3-year survival rates of R ＋ C group were 77.8 ％ （35/45）,44.4％ （20/45）,37.8 ％ （17/45）,and R group were 66.7％ （30/45）,31.1％ （14/45）,22.2％ （10/45）,there was no obviously difference （P ＞0.05）.The major toxic effects,acute gastrointestinal reactions,leukocytopenia,and thrombocytopenia （mostly class Ⅰ -Ⅱ） of NDP with 3D-CRT group were slightly higher than that of the 3D-CRT group.Conclusion：NDP combined with 3 D-CRT was effective,safe,and affordable for local advanced esophageal cancer.