替吉奥或卡培他滨同步三维适形放疗治疗中老年复发直肠癌疗效

Efficacy of three-dimensional conformal therapy combined with S-1 or capecitabine for recurrent rectal carcinoma in elderly patients

目的:观察三维适形放疗联合替吉奥或卡培他滨治疗老年局部复发直肠癌的近期疗效和安全性.方法:58例直肠癌术后局部复发患者,随机分为2组,试验组30例,给予放疗(1.8-2.0 Gy/d,5d/wk,总量为54-66 Gy)联合替吉奥;对照组28例,给予放疗(1.8-2.0 Gy/d,5 d/wk,总量为54-66 Gy)联合卡培他滨,21 d为1周期,接受2个以上周期治疗后,评价疗效和不良反应.结果:58例患者均可评价疗效,试验组和对照组有效率(response rate,RR)分别为73.3%(22/30)、71.4%(20/28),中位进展时间分别为9.2和8.2 mo,中位生存时间分别为16.9、17.2 mo,两组差异无统计学差异(P>0.05).试验组与对照组主要不良反应为骨髓抑制、胃肠道反应、皮疹、放射性直肠炎,均可耐受,两组差异无统计学意义(P>0.05),对照组手足综合征明显高于试验组,差异有统计学意义(P<0.05).结论:两组疗效相似,替吉奥联合三维适形放疗方案组手足综合征发生率较低,耐受性优于卡培他滨联合组,为中老年直肠癌复发临床治疗提供参考.

AIM： To evaluate the efficacy and safety of three- dimensional conformal therapy combined with S-1 or capecitabine for elderly patients with re- current rectal carcinoma. METHODS： Fifty-eight elderly patients with recurrent rectal cancer were randomly divided into two groups： a trial group （n = 30） and a control group （n = 28）. The treatment group re- ceived three-dimensional conformal radiation （a total of 54-66 Gy, 1.8-2.0 Gy/d, 5 d/wk） and S-1, while the control group were treated with the same radiation regimen and capecitabine. Each cycle lasted three weeks. The efficacy and toxic- ity were evaluated after two cycles of treatment. RESULTS： The efficacy and toxicity could be evaluated in 58 cases. There were no significant differences in overall response rate （73.3% vs 71.4%, P 〉 0.05）, median TTP （9.2 mo vs 8.2 mo, P 〉 0.05） or OS （16.9 mo vs 17.2 mo, P 〉 0.05） between the two groups. The most common toxicities were hematological, digestive toxic reactions, erythra and radiation enteritis, and all of them were tolerable and comparable between the two groups. However, the incidence of hand- foot syndrome in the control group was higher than that in the treatment group （P 〈 0.05）. CONCLUSION： The efficacy was comparable be- tween the two groups, but the incidence of hand- foot syndrome was lower in the S-l-based group.