IMRT联合替吉奥和奈达铂治疗局部晚期食管癌的初步研究

IMRT combined with S-1 and nedaplatin for locally advanced esophageal cancer: A preliminary study

目的探讨调强放疗联合替吉奥和奈达铂治疗局部晚期食管癌的疗效及安全性。方法20例初治的局部晚期食管鳞状细胞癌患者均接受化疗方案（奈达铂20mg／m2，dl-5＋替吉奥60mg／m2，dl-14，21天为1周期，共2周期），化疗同时行调强放疗，放疗剂量56～64Gy／28～32次。结果完全缓解16例（80．0％），部分缓解3例（15．0％），总有效率95．0％；1、2年的生存率分别为79．4％、62．6％。主要的血液学毒性为Ⅲ～Ⅳ级白细胞减少，发生率为20．0％（4／20），非血液学毒性主要为恶心、呕吐和放射性食管炎，均为I～Ⅱ级。结论调强放疗联合替吉奥和奈达铂方案治疗局部晚期食管癌有效，不良反应可接受。

Objective To evaluate the efficacy and safety of concurrent intensity-modulated radiotherapy（ IMRT）with S-1 and nedaplatin for locally advanced esophageal cancer. Methods Twenty patients with locally advanced squamous cell carcinoma of esophagus received S-1（ 60 mg / m2,d1- 14） and nedaplatin（ 20 mg/m2,d1- 5） with 21 d as a cycle for two cycles. Concurrently,IMRT was given with a total dose of DT 56 ～ 64 Gy /28 ～ 32 f. Results Sixteen patients（ 80. 0%） achieved complete response,3 patients（ 15. 0%） had partial response with an overall response rate of 95. 0%,The 1-,2-year overall survival rates were 79. 4% and 62. 6% respectively. The main hematological toxicity was leucocytopenia,4 patients（ 20. 0%） had grade 3 or 4 leucocytopenia. The major non-hematological toxicities were nausea,vomiting and radiation esophagitis,mostly of grades 1 and 2. Conclusion Concurrent chemoradiotherapy with S-1 and nedaplatin for patients with locally advanced esophageal cancer was a feasible regimen with tolerable adverse effects.