TOMOX方案联合三维适形放射治疗中晚期食管癌的近期疗效及不良反应观察

The study on short-time therapeutic effect and adverse reaction observation of TOMOX regimen combined with three dimensional conformal radiotherapy for middle and advanced esophageal cancer

目的:研究雷替曲塞联合奥沙利铂(TOMOX)方案联合三维适形放射治疗对中晚期食管癌的疗效及不良反应。方法:选取51例确诊为食管癌的住院患者,通过随机数表法将其分为观察组(27例)与对照组(24例)。对照组给予三维适形放射治疗;观察组在对照组治疗方法的基础上增加TOMOX方案。对比两组患者的治疗效果、控制期、生存期和不良反应。结果:治疗后观察组完全缓解(CR)率和部分缓解率(PR)均明显高于对照组,两组比较有显著差异(x^2=11.411,x^2=4.668;P<0.05);观察组的总有效率为96.30%,显著高于对照组的58.33%,两组比较有显著差异(x^2=40.767,P<0.05);观察组的2年控制率和2年生存率均明显高于对照组,两组比较有显著差异(x^2=5.704,x^2=12.602;P<0.05);观察组的急性放射性肺炎发生率和胃肠道反应率均低于对照组,两组比较有差异(x^2=9.191,x^2=4.700;P<0.05);观察组的末梢神经炎发生率和白细胞减少率低于对照组,两组比较无差异(x^2=1.454,x^2=2.921;P>0.05);观察组的急性食管炎发生率高于对照组,两组比较有差异(x^2=8.991,P<0.05)。结论:TOMOX方案联合三维适形放射治疗能有效提高短期疗效和长期生存率,降低不良反应。

Objective To explore the efficacy and adverse reaction of TOMOX regimencombined with three dimensional conformal radiotherapy in the treatment of middle and advanced esophageal cancer.Methods： 51 cases of hospitalized patients with esophageal cancer were selected from January 2013 to December 2015in our hospital who were divided into observation group （n=27） and control group （n=24） by random number tablemethod. The control group was treated with three dimensional conformal radiotherapy, and the observation group wasadded with the TOMOX scheme based on the control group. Compare the efficacy of the two groups, the control period,the survival period, the toxicity and side effects. Results： The rate of complete response（CR）and partial response（PR） in the observation group was significantly higher than that in the control group, the difference was statisticallysignificant （P〈0.05）. The total effective rate of the observation group was 96.30%, which was significantly higherthan that of the control group 58.33% （P〈0.001）. The 2 year control rate and 2 years survival rate of the observationgroup was significantly higher than that of the control group （P〈0.05）. The incidence of acute radiation pneumoniaand gastrointestinal reaction in observation group was lower than the control group, the difference was statisticallysignificant （P〈0.05）.The neuritis rate and leukopenia of observation group was lower than the control group, butthe difference was not statistically significant （P〉0.05）. The rate of acute esophagitis in the observation group groupwas higher than that in the control group, the difference was statistically significant （P〈0.05）. Conclusion： TOMOXcombined with three-dimensional conformal radiation therapy can effectively improve the short-term efficacy and longtermsurvival rate, reduce adverse reactions.