三维适形放疗与同步化疗食管癌的效果及不良反应

Efficacy of Three-dimensional Conformal Radiotherapy and Concurrent Chemotherapy for Esophageal Carcinoma and Adverse Reactions

目的探究三维适形放疗同步化疗方案对食管癌患者癌肿的控制效果及不良事件的影响,并为临床治疗提供循证数据支撑。方法将78例食管癌患者按随机数字表法进行分组,分别设为研究组和对照组,每组各39例。对照组行三维适形放疗,研究组在此基础上给予紫杉醇联合顺铂同步化疗。结果研究组CR 16例,PR 20例,有效率为92.3%(36/39);对照组CR 12例,PR 19例,有效率为79.5%,差异有统计学意义(P<0.05)。研究组1年局控率为84.6%(33/39),对照组为76.9%(30/39),差异有统计学意义(P<0.05)。研究组1年生存率为79.5%(31/39),对照组为71.8%(28/39),差异有统计学意义(P<0.05)。研究组放射性食管炎Ⅱ度及以上发生率为79.5%,对照组为48.7%,差异有统计学意义(P<0.05);研究组Ⅲ度及以上放射性食管炎发生率为30.8%,对照组为23.1%,差异无统计学意义(P>0.05)。研究组Ⅱ度及以上白细胞减少发生率为48.7%,对照组为33.3%,差异有统计学意义(P<0.05);研究组Ⅲ度及以上白细胞减少发生率为23.1%,对照组为17.9%,差异无统计学意义(P>0.05)。结论三维适形放疗同步化疗相较于单纯放疗,能有效提高中晚期食管癌患者抗癌效果,且不良反应可控,值得进一步推广。

Objective To explore efficacy of three-dimensional conformal radiotherapy and concurrent chemotherapy for esophageal carcinoma and adverse reactions,and provide evidence-based data for clinical treatment.Methods 78 cases of esophageal cancer,using random digits table,were divided into the study group and the control group,each group with 39 cases.The control group received three dimensional conformal radiotherapy,the study group was given synchronous chemotherapy of paclitaxel combined with cisplatin based on the control group.Results In the study group,CR was 16 cases,PR was 20 cases,efficiency was 92.3%（36 /39）,in the control group,CR was 12 cases,PR was 19 cases,efficiency was 79.5%,the difference was statistically significant（P〈0.05）.1-year local control rate of the study group was 84.6%（33 /39）,and that of the control group was76.9%（30 /39）,the difference was statistically significant（P〈0.05）.1-year survival rate of the study group was 79.5%（31 /39）,and that of the control group was 71.8%（28 /39）,the difference was statistically significant（P〈0.05）.The incidence rate of radioactive esophagitis above Ⅱ degree of the study group was 79.5%,and that of the control group was 48.7%,the difference was statistically significant（P〈0.05）; The incidence rate of radioactive esophagitis above Ⅲ degree of the study group was 30.8%,and that of the control group was 23.1%,there had no significant difference（P〈0.05）.The incidence rate of above Ⅱ degree leukopenia of the study group was 48.7%,and that of the control group was 33.3%,the difference was statistically significant（P〉0.05）; The incidence rate of above Ⅲ degree leukopenia of the study group was 23.1%,and that of the control group was 17.9%,there had no significant difference（P〉0.05）.Conclusion Compared with radiotherapy alone,Three-dimensional conformal radiotherapy plus chemotherapy can effectively improve anticancer effect for advanced esophageal cancer with tolerable toxities,it is worthy of further promotion.