放疗联合希罗达与放疗联合顺铂治疗局部晚期食管癌的临床对照研究

Clinical Comparative Study of Radiotherapy Combined with Xeloda and Cisplatin Respectively in the Treatment for Locally Advanced Esophagus Carcinoma

[目的]比较希罗达/顺铂分别联合放疗治疗局部晚期食管癌的疗效和不良反应。[方法 ]将72例晚期食管癌患者随机分为两组,希罗达组35例,于放疗期间口服希罗达,每日2次,每次500mg,至放疗结束;顺铂组37例,放疗同期联合顺铂化疗,自放疗开始每周静滴顺铂30mg/m^2,共6次。观察和比较两组患者的疗效及不良反应。[结果 ]同期放化疗结束后复查食管点片,放疗联合希罗达组总有效率(Ⅰ级+Ⅱ级+Ⅲ级)为88.6%,放疗联合顺铂组总有效率(Ⅰ级+Ⅱ级+Ⅲ级)为91.9%,两组总有效率差异无统计学意义(P>0.05)。希罗达同步放疗组1、2、3年生存率分别为60.0%、40.0%和20.0%;顺铂同步放疗组则依次为64.9%、43.2%和21.6%,两组生存率差异无统计学意义(P>0.05)。但希罗达组的骨髓抑制、胃肠道反应及肾毒性较顺铂组轻。[结论]希罗达同步放疗和顺铂同步放疗治疗局部晚期食管癌临床疗效近似,但希罗达联合放疗的不良反应轻,治疗耐受性较好,值得临床推广。

[Purpose] To compare the curative effects and adverse reactions radiotherapy combined with Xeloda and Cisplatin respectively in the treatment of locally advanced esophagus carcinoma. [Methods] A total of 72 patients of advanced esophagus were chosen,and were divided randomly into two groups. One group was treated with radiotherapy combined with taking oral Xeloda 500 mg twice a day from the beginning of radiotherapy to the finish. The control group was treated with radiotherapy combined with Cisplatin injection at 30mg/m^2 every week for six times from the first week of radiotherapy. [Results] The total effect rate of radiotherapy combined with Xeloda group and Cisplatin group was 88.6% and 91.9% respectively after a corresponding treatment period. There was no significant difference in the ration of overall response and survival between two groups（P〉0.05）.However,the group received radiotherapy combined with oral Xeloda have less side effect of bone marrow,gastroenteric reaction and kidney toxicity compared with the Cisplatin chemotherapy group. [Conclusion] Though radiotherapy combined with oral Xeloda and Cisplatin chemotherapy can result in equally efficacy in the treatment of locally advanced esophagus,radiotherapy combined with oral Xeloda is better worth of clinical spread application for its less toxic side-effects and better tolerability.