加味参麦汤对中晚期食管癌三维适形放疗治疗的影响

Effect of Jiawei Shenmai Decoction on medium and advanced stage esophageal carcinomas in three-dimensional conformal radiotherapy

目的观察加味参麦汤在中晚期食管癌三维适形放疗治疗中的减毒增效作用。方法将63例中晚期食管癌患者随机分为3组,各21例,均采用三维适形放射治疗,放疗对照组(A组)口服配制液,参麦注射液组(B组)予参麦注射液静脉滴注(1次/d),加味参麦汤联合放疗组(C组)同时口服加味参麦汤(50 mL,2次/d),至放疗结束。结果 C组临床获益率高于A组和B组,差异有统计学意义(P<0.05);在生存质量和症状缓解评价方面,C组优于A组和B组(P<0.05);TGF-β1和IL-6在放疗后3组结果无统计学差异(P>0.05)。结论加味参麦汤对中晚期食管癌患者三维适形放疗治疗没有增效的作用;对早期急性放射反应起到一定的减毒作用,但不是通过影响细胞因子TGF-β1和IL-6水平实现的。

Objective To observe the toxicity reducing and efficacy enhancing effect of three-dimensional confonnal radio- therapy combination with Jiawei Shenmai Decoction in treatment of medium and advanced stage esophageal carcinomas pa- tients. Methods 63 mediate and advanced stage esophageal carcinomas patients were randomized to three groups. All of the three groups received radiotherapy with three-dimensional conformal radiotherapy technology. Morever, group B received ra- diotherapy combined with Shenmai injection, and group C received radiotherapy combined with Jiawei Shenmai Decoction （50 mL, 3/d）. That compared the differences of the curative effects among the three groups after treatment. Results Group C had the higher CBR, and in terms of survival quality, better than other groups （ P 〈 0.05）. In the way of dysphagia and swallowing pain, group C is better than that of group A and group B. The levels of TGF-β1 and IL-6 in three groups after ra- diotherapy had no statistical difference （ P 〉 0.05）. Conclusion Radiotherapy combined with Jiawei Shenmai Decoction can no increase the clinical efficacy. However, it improve the radiation tolerance of treatment, but it get the clinical benefit to patients to a certain extent without up-regulation of TGF-β1 and IL-6.