IMRT同步化疗治疗中晚期食管癌的临床效果观察

Clinical Observation of IMRT Concurrent Chemotherapy for Middle and Advanced Esophageal Cancer

目的探讨IMRT同步化疗治疗中晚期食管癌的临床疗效及毒副作用。方法选择连云港市第一人民医院60例中晚期食管癌患者,随机分为同步治疗组(30例)和单纯IMRT组(30例)。同步治疗组:IMRT+同步化疗2周期,序贯化疗4周期。单纯IMRT组:单纯IMRT,序贯化疗6周期。化疗方案:同步化疗2周期,28天为1个周期。多西他赛60 mg/天,第1天、第8天加奈达铂30 mg。比较分析2组有效率、局控率及不良反应发生率。结果同步治疗组有效率高于单纯IMRT组(96.67%vs73.33%),差异有统计学意义(P<0.05)。同步治疗组1,2年局控率分别为86.67%、63.33%,均高于单纯IMRT组1,2年的局控率(70.00%、36.67%),差异有统计学意义(P<0.05)。同步治疗组白细胞减少和放射性食管炎发生率分别为90.00%、80.00%,均高于单纯IMRT组的56.67%、53.33%,差异有统计学意义(P<0.05)。结论 IMRT同步化疗治疗中晚期食管癌临床疗效优于单纯IMRT治疗,但不良反应发生率有所增高,经临床对症干预后,均可完成治疗。

Objective To investigate the clinical efficacy and side effects of IMRT concurrent chemotherapy for middle and advanced esophageal cancer. Methods 60 eases of middle and advanced esophageal cancer were randomly divided into syn-~ chronous treatment group（30 eases） and simple IMRT group（30 eases）. Synchronization therapy group received IMRT ＋ 2 cy- cles of concurrent chemotherapy, sequential chemotherapy of 4 cycles. Simple IMRT groups received simple IMRT, sequential chemotherapy of 6 cycles. Chemotherapy regimen was 2 cycles of chemotherapy, a cycle of 28 days, doeetaxel 60 mg,/day on day 1, day 8 add nedaplatin 30 mg. Comparative analysis of the efficiency, local control rates and incidence of adverse reactions of the 2 groups were made. Results Efficacy of concurrent therapy group was higher than IMRT group （96.67% vs73.33% ）, the difference was statistically significant（P 〈 0.05 ）. 1-, 2-year local control rates in synchronization therapy group were 86.67%, 63.33% ,which were higher than those of IMRT group （70.00% ,36.67% ）, the difference was statistically significant （P 〈 0.05 ）. Leukopenia and radiation esophagitis rates in synchronization therapy group were 90.00%, 80.00% , which were higher than 56.67% pure IMRT group,53.33%, the difference was statistically significant （ P 〈 0.05 ）. Conclusion IMRT with concurrent chemotherapy for middle and advanced esophageal carcinoma is better than IMRT treatment, but the incidence of side effects increased. After symptomatic clinical intervention, both treatment can be completed.