调强放疗联合紫杉醇及奈达铂化疗治疗食管癌的临床观察

Clinical Study of Intensity-modulated Radiotherapy Combined with Paclitaxel and Nedaplatin in the Treatment of Esophageal Cancer

目的研究调强放疗联合紫杉醇及奈达铂化疗治疗食管癌的临床价值。方法将80例食管癌患者随机分为治疗组40例(调强放疗联合紫杉醇及奈达铂化疗),对照组40例(三维适形放疗联合紫杉醇及奈达铂化疗)。全部患者治疗结束1个月后对产生数据进行综合分析,比较2组疗效及安全性。结果治疗组与对照组近期疗效评价总有效率分别为90.0%、80.0%,组间差异有统计学意义(P<0.05);对照组、治疗组放射性食管损伤分别为38例(95.0%)、36例(90.0%),恶心、呕吐分别为17例(42.5%)、19例(47.5%),白细胞计数下降分别为28例(70.0%)、29例(72.5%),血小板计数下降分别为13例(32.5%)、13例(32.5%),差异均无统计学意义(P>0.05);急性放射性肺炎分别为12例(30.0%)、3例(7.5%),差异有统计学意义(P<0.05)。2组肺部V20、V30差异有统计学意义(P<0.05)。结论调强放疗联合紫杉醇及奈达铂化疗治疗中晚期食管癌的近期疗效优于三维适形放疗联合紫杉醇及奈达铂化疗,且对病灶周围组织的伤害更小。

Objective To analyze the clinical value of intensity-modulated radiotherapy combined with paclitaxel and nedaplatin in the treatment of esophageal carcinoma. Methods 80 cases of esophageal cancer patients were randomly divided into the treatment group（ 40 cases）（ IMRT plus paclitaxel and nedaplatin chemotherapy）,the control group（ 40 cases）（ three dimensional conformal radiotherapy combined with paclitaxel and nedaplatin chemotherapy）. 1 months after treatment,the data were analyzed and the efficacy and safety of the 2 groups were compared. Results Evaluation of therapeutic effects of the treatment group and the total effective rate of the experimental group were 90. 0% and 80. 0%,there was significant difference between the2 groups（ P〈0. 05）; In the control group,and the treatment group,radiation esophagitis were 38 cases（ 95. 0%）,36 cases（ 90. 0%）,nausea and vomiting were 17 cases（ 42. 5%）,19 cases（ 47. 5%）,white blood cell count decreased in 28 cases（ 70. 0%）,29 cases（ 72. 5%）,decreased platelet count were 13 cases（ 32. 5%）,13 cases（ 32. 5%）,there were no significant differences（ P〉0. 05）; acute radiation pneumonia were 12 cases（ 30. 0%）,3 cases（ 7. 5%）,the difference was statistically significant（ P〈0. 05）. The difference of lung V20 and V30 between the 2 groups was statistically significant（ P〈0. 05）. Conclusion The short-term effect of intensity-modulated radiotherapy combined with paclitaxel and nedaplatin in the treatment of advanced esophageal cancer is better than that of three-dimensional conformal radiotherapy combined with paclitaxel and nedaplatin,and the damage to surrounding tissue is less.