调强适形放疗联合多西紫杉醇和奈达铂治疗局部晚期食管癌的临床观察

Clinical Observation of Intensity Modulated Radiotherapy Combined with Docetaxel and Nedaplatin in the Treatment of Locally Advanced Esophageal Cancer

目的观察调强适形放疗联合多西紫杉醇和奈达铂同步化疗治疗局部晚期食管癌的疗效及安全性。方法选取我院收治的经病理证实的局部晚期食管癌患者48例为研究对象,将其随机分为同步放化疗组(CRT组)和单纯放疗组(RT组)各24例。RT组患者采用调强适形放射治疗(IMRT),CRT组患者在RT组治疗基础之上采用多西紫杉醇+奈达铂(DN)进行治疗。治疗后1个月比较两组的近期疗效、生活质量(用KPS标准评价)和毒副反应,并随访评估远期疗效。结果 CRT组的近期总有效率为91.7%,显著高于RT组的62.5%,差异有统计学意义(P<0.05);CRT组的疾病控制率为100.0%,高于RT组的91.7%,但差异无统计学意义(P>0.05);CRT组1年生存率为83.3%,高于RT组的54.2%,差异具有统计学意义(P<0.05)。两组患者生活质量均有所提高,但组间相比无显著差异(P>0.05);两组毒副反应发生率和程度相比无显著差异(P>0.05)。结论调强适形放疗同步化疗治疗局部晚期食管癌的近期疗效及1年生存率优于单纯调强适形放疗,毒副反应可以耐受,值得进一步研究。

Objective To observe the efficacy and safety of intensity modulated radiotherapy（IMRT） combined with chemotherapy of docetaxel and nedaplatin in treating locally advanced esophageal cancer. Methods 48 cases of patients with pathologically proved locally advanced esophageal cancer treated in our hospital were selected as objects and randomly divided into chemoradiotherapy group（CRT group） and simple radiotherapy group（RT group）, with 24 cases in each group. Patients in RT group were given IMRT, while patients in CRT group were given chemotherapy with docetaxel and nedaplatin（DN） on the basis of RT group. The short-term effect, life quality（evaluated by KPS standard） and side effect were compared after 1 month of the treatment, the long-term effect was evaluated by following-up. Results The recent total effective rate of CRT group was 91.7%, higher than 62.5% of RT group, with statistical difference（P0.05）; the disease control rate of two groups had no statistical difference（100.0% vs 91.7%, P 0.05）; the one-year survival rate of CRT group was 83.3%, higher than 54.2% of RT group, with statistical difference（P 0.05）. The life quality of two groups were improved, but had no statistical difference（P 0.05）; the side effect of two groups had no statistical difference（P 0.05）. Conclusions Intensity modulated radiotherapy combined with chemotherapy has better short-term effect and higher one-year survival rate than simple radiotherapy in the treatment of locally advanced esophageal cancer with tolerable side effect, which deserves further research.