紫杉醇联合氟尿嘧啶的同期放疗与顺铂联合氟尿嘧啶同期放疗治疗局部晚期食管鳞癌的安全性比较

Comparison of Concurrent Radiotherapy of Paclitaxel and Fluorouracil and Concurrent Radiotherapy of Cis-platinum Complexes Combined with Fluorouracil

目的比较紫杉醇联合氟尿嘧啶(TF)放化疗与顺铂联合氟尿嘧啶(PF)放化疗两种方案在食管癌放射治疗中发生的不良反应。方法选择江南大学附属医院自2014年10月—2017年2月所收治的103例患者,随机分成TF组及PF组,TF组患者在放疗期间同步使用紫杉醇联合氟尿嘧啶化疗,PF组则使用顺铂联合氟尿嘧啶化疗,观察比较两组治疗期间及治疗后发生的不良反应。结果 TF组3、4级白细胞减低率为36.5%,3、4级急性放射性肺炎发生率为15.4%,高于PF组(分别为17.6%,3.9%),PF组3、4级呕吐反应率17.6%,为高于TF组的1.9%,差异有统计学意义(P<0.05)。结论食管癌患者采用紫杉醇联合氟尿嘧啶同期放化疗时,血液学毒性及放射性肺炎发生率相对较高,治疗期间需加强预防与对症治疗,而使用顺铂联合方案治疗时,需关注呕吐等消化系统不良反应。

Objective To compare the adverse reactions of concurrent radiotherapy of paclitaxel and fluorouracil and concurrent radiotherapy of cis-platinum complexes combined with fluorouracil.Methods 103 cases of patients with esophageal cancer admitted and treated in our hospital from October 2014 to February 2017 were selected and randomly divided into the TF group and PF group,and the TF group used the concurrent radiotherapy of paclitaxel and fluorouracil,while the PF group used the concurrent radiotherapy of cis-platinum complexes combined with fluorouracil,and the adverse reactions during the treatment period and adverse reactions were compared between the two groups.Results The leukocyte reduction rate of level 3 and level 4 and incidence rate of acute radiation pneumonitis of level 3 and level 4,in the TF group were higher than those in the PF group(36.5%,15.4%vs 17.6%,3.9%),and the vomiting reaction rate of level 3 and level 4 in the PF group was higher than that in the TF group(17.6%vs 1.9%),and the difference was statistically significant(P<0.05).Conclusion The incidence rates of hematologic toxicities and radiation pneumonitis of concurrent radiotherapy of paclitaxel and fluorouracil are relatively high,and we need the prevention and systematic treatment during the treatment and pay attention to the adverse reactions of digestive system such as vomiting when using the cis-platinum complexes combined with fluorouracil.