食管癌再程放疗联合替吉奥的疗效评价

Therapeutic effects of reradiotherapy combined with S-1 in treatment of recurrent esophageal carcinoma

目的:观察放疗后复发的食管癌患者行再程三维适形放疗联合替吉奥的临床疗效.方法:61例放疗后复发的食管癌患者按治疗方案不同分为研究组31例和对照组30例,所有患者均接受1.8-2.0 Gy/次,5次/wk,靶区处方剂量为45-55 Gy的再程放疗,其中研究组于放疗开始当天口服替吉奥60 mg/m2,2次/d,连用14 d后,间隔7 d,21 d为1个周期,共用两周期,对照组仅接受再程放疗.结果:两组CR率分别为38.7%、26.7%,差异无统计学意义(P>0.05),有效率分别为74.2%、46.7%,差异具有统计学意义(P<0.05).研究组1、2、3年生存率分别为54.8%、38.7%、16.1%,对照组1、2、3年生存率分别为43.3%、20.0%、6.7%,两组生存曲线差异具有统计学意义(P<0.05).结论:替吉奥联合三维适形放疗治疗根治性放疗后复发的食管癌可以提高近期疗效,延长生存,不良反应轻,患者耐受性好.

AIM： To evaluate the efficacy and safety of S-1 combined with three dimensional conformal ra- diotherapy in the treatment of recurrent esopha- geal carcinoma after radiotherapy. METHODS： Sixty-one esophageal carcinoma patients who recurred after they had received radical radiotherapy and were confirmed by pa- thology were divided into either a study group or a control group according to whether receiv- ing S-1 or not. All patients received three dimen- sional conformal radiotherapy at 1.8-2.0 Gy each time, 5 fractions a week to a total dose of 45-55 Gy. The patients in the study group received S-1 at a dose of 60 mg/（ma.d） for 14 days, every 3 weeks, totally 6 wk when they started receivingre-radiotherapy. The control group merely re- ceived re-radiotherapy. RESULTS： The complete response rate was 38.7% in the study group, and 26.7% in the control group （P 〉 0.05）. The effective rate was 74.2% in the study group, and 46.7% in the control group （P 〈 0.05）. The 1-, 2- and 3-year survival rates were 54.8%, 38.7% and 16.1% in the study group, and 43.3%, 20.0% and 6.7% in the control group （P 〈 0.05）. CONCLUSION： For recurrent esophageal carci- noma after radical radiotherapy, S-1 combined with three dimensional conformal radiotherapy can improve the efficacy and prolong survival period without a significant increase in acute ad- verse effects of radiotherapy.