小剂量TP方案同步放化疗治疗老年人局部晚期食管癌效果观察

Effect observation of low dose of docetaxel and cisplatin combined with radiotherapy on the elderly patients with esophageal cancer

目的探讨小剂量多西他赛＋顺铂（TP）每周方案化疗联合放疗治疗老年人局部晚期食管癌的临床疗效。方法回顾性分析65例老年局部晚期食管癌患者的临床资料，其中TP方案化疗联合放疗（放化组）33例，单纯放疗（单放组）32例。两组放疗均采用三维适形放疗（3D-CRT）。放化组采用多西他赛40mg／次＋顺铂40mg／次，于放疗第1、8、15、22、36天使用。结果放化组有效（完全缓解＋部分缓解）29例，有效率为87．8％；单放组有效21例，有效率为65．6％，两组差异有统计学意义（P〈0．05）；中位疾病进展时间放化组为5．5个月，单放组为4．3个月，两组差异有统计学意义（P〈0．05）；1年生存率放化组为69．6％，单放组为59.3％，两组差异无统计学意义（P〉0．05）。胃肠道反应、放射性食管炎等发生率放化组均高于单放组（P〈0．05）。结论小剂量TP方案同步放化疗治疗老年人局部晚期食管癌疗效显著，不良反应可耐受。

Objective To investigate the efficacy and toxicity of low dose of docetaxel and cisplatin （TP） combined with radiotherapy in the treatment of elderly patients with esophageal cancer. Methods The data of 65 elderly patients with esophageal cancer were studied retrospectively, including 33 patients treated by TP combined with radiotherapy （chemoradiotherapy group） and 32 patients by radiotherapy only （radiotherapy group）. Patients in both groups received 3D conventional radiotherapy （3D-CRT）. In chemoradiotherapy group, 40 mg/lf docetaxel and 40 mg/lf cisplatin were administered once a week on the 1st, 8th, 15th, 22th, 36th day of five successive weeks. Results In chemoradiotherapy group and radiotherapy group, the response （CR＋RR） rates were 87.8 % （29/33） and 65.6 % （21/32）, respectively （P 〈 0.05）, the median TrPs were 5.5 months and 4.3 months, and the difference had statistically significant （P 〈 0.05）. The 1-year survival rate was 69.6 % and 59.3 % in chemoradiotherapy group and radiotherapy group, respectively, and there was no statistically significant difference between both groups （P 〉 0.05）. The incidences of esophagitis and gastrointestinal tract were slightly higher in chemoradiotherapy group than those in radiotherapy group （P 〈 0.05）. Conclusion Concurrent radiotherapy and chemotherapy with low dose TP can treat effectively esophageal cancer in elderly patients with the tolerable toxic reactions.