后程加速超分割三维适形放疗同步化疗治疗食管癌的疗效分析

Efficacy of three dimensional conformal late course accelerated hyperfraction radiotherapy and concurrent chemotherapy on esophageal carcinoma

[目的]观察后程加速超分割三维适形放疗联合同步化疗治疗中晚期食管癌的临床疗效。[方法]104例中晚期食管癌患者随机分为2组,观察组(51例)采取后程加速超分割三维适形放疗联合紫杉醇、奈达铂化疗治疗;对照组(53例)仅行后程加速超分割三维适形放疗。观察指标为治疗后3个月疗效、1年生存率及不良反应发生率,并采用EORTC癌症患者生命质量测定量表QLQ-C30(V3.0)中文版评价治疗前后生命质量。[结果]治疗后3个月,观察组有效率显著高于对照组(P<0.05)。1年生存率比较,观察组高于对照组,但差异无统计学意义。治疗前2组QLQ-C30量表指标比较差异无统计学意义,治疗结束时观察组躯体功能、角色功能、情绪功能、社会功能评分显著低于对照组,而总体症状明显高于对照组(P<0.05)。治疗后3个月,观察组躯体功能、情绪功能、社会功能评分高于对照组,而总体症状评分低于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率高于对照组(P<0.05)。[结论]后程加速超分割三维适形放疗联合同步化疗治疗食管癌能提高近期疗效,虽不良反应增多,影响治疗期间生命质量评分,但均可耐受,短期内即可恢复且有提高。

[Objective]To evaluate the efficacy of three dimensional conformal late course accelerated hyperfraction radiotherapy（LCAFR-3DCRT）and concurrent chemotherapy for middle-advanced esophageal carcinoma.[Methods]One hundred and four cases of middle-advanced esophageal cancer were divided into two groups.The observation group was treated with LCAFR-3DCRT plus 2cycles of concurrent chemotherapy（Paclitaxel＋Nedaplatin）,and the control group was treated with LCAFR-3DCRT only.Clinical efficacy after 3months,1-year survival rates and adverse reaction were observed,and EORTC QLQ-C30 was used to evaluate the life quality before and after treatment.[Results]The clinical efficacy in the observation group after 3months of treatment was higher than the control group（82.4% vs 64.2%,χ2=4.377,P0.05）.There was no significant difference of 1-year survival rates between the two groups.At the endpoint,the scores of somatic function,role function,emotional function and social function in the observation group were significantly lower than those in the control group,and the score of general symptoms was higher.But 3months later,the scores of somatic function,emotional function and social function in the observation group were significantly higher than those in the control group,and the score of general symptoms was lower.The adverse reaction was severer in the observation group than in the control group,[Conclusion]LCAFR-3DCRT combined with concurrent chemotherapy for esophageal carcinoma can improve the short-term clinical efficacy.Although this treatment has more adverse reactions and affects the lifequality of patients during the treatment,they can be tolerated and will recover and improve in a short term.