顺铂联合多西他赛同步放化疗对局部晚期食管胃交界癌患者生存质量的影响

Effect of concurrent chemoradiotherapy with cisplatin and docetaxel on survival quality of patients with local advanced esophageal gastric junction adenocarcinoma

目的探讨顺铂联合多西他赛同步放化疗对局部晚期食管胃交界癌患者生存质量的影响。方法局部晚期食管胃交界癌患者94例随机分为两组。在放疗基础上,观察组(48例)采用静脉滴注顺铂25mg/m^2和多西他赛75mg/m^2化疗,对照组(46例)予静脉滴注顺铂25mg/m^2和氟尿嘧啶500mg/m^2化疗。化疗21d为1个疗程,两组均连续用药2个疗程。比较两组治疗前后卡氏(KPS)评分、体质量变化、生活质量(QOL)评分、临床疗效及生存率情况。结果治疗后,观察组KPS评分[(74.68±5.33)分vs.(65.74±6.43)分]和体质量[(70.38±5.02)kg vs.(60.52±1.54)kg]均优于对照组(P<0.01),临床总有效率(93.75%vs.76.09%)、QOL评分[(31.19±6.04)分vs.(24.02±9.62)分]及5年生存率均高于对照组(20.83%vs.6.52%)(P<0.05或P<0.01)。结论与采用顺铂联合氟尿嘧啶同步放化疗比较,采用顺铂联合多西他赛同步放化疗更能提高局部晚期食管胃交界癌患者生存质量。

Objective To explore the effect of concurrent chemoradiotherapy with cisplatin and docetaxel on survival quality of patients with local advanced esophageal gastric junction ad ad Methods A total of 94 patients with local advanced esophageal gastric junction was randomly divided into two groups. Based on radiotherapy in both groups, concurrent chemotherapy was performed with combined use of cisplatin 25 mg/m^2 and docetaxel 75 mg/m^2 （group A,48 cases） or cisplatin 25 mg/m^2 and fluorouracil 500 mg/m^2 （group B,46 cases）, which were intravenously infused daily for 21 days as a course of treatment. After two courses of treatment, clinical efficacy was evaluated by Karnofsky（KPS） score, the change of body mass and the quality of life（QOL） score. The survival rate was calculated as well. Results After treatment, the KPS scores[ （74. 68 ± 5.33） points vs. （ 65.74 ± 6.43） points], body mass [ （ 70.38 ± 5.02） kg vs. （60. 52±1.54） kg], clinical efficacy（93.75% vs. 76.09%）, and QOL scoresl-（31.19 ± 6.04） points vs. （24. 02±9.62） points] were better in group A than those in group B（P〈0. 05 or P〈0. 01）. The 5-year survival rate was higher in group A than that in group B （20.83% vs. 6.52~） （P^0. 05）. Conclusion Compared to concurrent chemoradiotherapy with cisplatin and fluorouracil, concurrent chemoradiotherapy with cisplatin and docetaxel is better in improving survival quality of the patients with local advanced esophageal gastric junction adenocarcinoma.