调强放疗联合紫杉醇治疗食管癌术后纵隔淋巴结转移疗效观察

Efficacy of intensity modulated radiation therapy combined with paclitaxel for mediastinal lymph node metastasis of esophageal carcinoma after surgery

目的探讨调强放疗联合紫杉醇治疗食管癌术后纵隔淋巴结转移的临床疗效。方法选取新乡市中心医院收治的食管癌术后纵隔淋巴结转移患者55例，随机分为对照组27例和试验组28例。对照组单用调强放疗；试验组调强放疗同时给予低剂量周方案紫杉醇化疗。结果治疗后两组临床疗效比较，差异有统计学意义（P=0．044）。常见不良反应主要有骨髓抑制及消化道反应等，应用升白细胞、止吐药物后缓解。对照组和实验组中位生存时间分别为362d和498d，1、2、3年生存率分别为40．6％、21．5％、11．3％和79．8％、46．2％、19．6％（P〈0．05）。结论调强放疗联合低剂量周方案紫杉醇治疗食管癌术后纵隔淋巴结转移较单纯放疗临床疗效好，1、2、3年生存率提高。

Objective To observe the clinical effect ofintensity modulated radiation therapy （IMRT） combined with paclitaxel on mediastinal lymphnode metastasis of esophageal carcinoma after surgery. Methods Fifty-five esophageal carcinoma patients with mediastinal lymphnode metastasis after surgery were randomly divided into experimental group （n = 27 ） and control group （n = 28 ）. Control group accepted IMRT only, and experimental group had radiotherapy plus concomitant pacli- taxel of low dose and weekly plan. Results After treatment, the difference of clinical effect between the two groups was statistically significant （P = 0. 044 ）. The median survival time were 362 days and 498 days. The I ,2 and 3 year survival rate was 40.6% ,21.5% ,11.3% and 79. 8% ,46.2% ,19.6% （P 〈 0. 05 ）. Conclusions IMRT combined with paclitaxel of low dose and weekly plan has better efficacy and less toxieities than only IMRT.