DP与PF方案化疗同步调强适形放疗治疗局部中晚期食管鳞癌的回顾性研究

A comparative study of DP and PF regimen chemotherapy combined with intensity-modulated radiotherapy in the treatment of locally advanced esophageal squamous cell carcinoma

目的比较DP(多西他赛+顺铂)方案化疗及PF(顺铂+5-氟尿嘧啶)方案联合调强适形放疗(Intensity-modulated Radiotherapy,IMRT)方案在无远处转移食管鳞癌患者中的不良反应、近期疗效和远期效果,从而评估DP、PF同步放化疗对局部中晚期食管鳞癌的临床价值。方法回顾性分析2014年1月~2016年6月收治的中晚期食管鳞癌患者共94例,分为研究组及对照组,研究组治疗方案为多西他赛联合顺铂同步放化疗(DP组),对照组治疗方案为5-氟尿嘧啶联合顺铂同步放化疗(PF组),每组47例,化疗分别在放疗的第1、5周给予。对比两组患者临床疗效、放化疗不良反应。结果研究组近期总有效率为83.0%,高于对照组的63.8%(P<0.05);研究组和对照组1年、3年生存率分别为78.72%和46.81%,65.96%和27.66%,研究组中位生存时间28.0个月显著高于对照组18.3个月,差异有统计学意义(P<0.05);两组胃肠道反应、血液毒性、放射性食管炎、放射性肺炎等发生率比较差异无统计学意义(P>0.05)。结论与PF方案对比,DP方案同步调强适形放疗可提高患者近期疗效,显著提高1年、3年生存率,延长中位生存时间,且毒副作用未见明显增加,值得推荐。

Objective To compare the adverse reactions,short-term efficacy and long-term effects of DP(docetaxel+cisplatin)chemotherapy and PF(cisplatin+5-fluorouracil)chemotherapy combined with intensity-modulated radiotherapy(IMRT)in squamous cell carcinoma patients without distant metastasis,so as to evaluate the clinical value of DP and PF concurrent chemoradiotherapy for locally advanced esophageal squamous cell carcinoma.Methods 94 cases of advanced esophageal squamous cell carcinoma admitted to hospital from January 2014 to June 2016 were analyzed retrospectively.They were divided into study group and control group with 47 cases in each group.The study group were given DP concurrent radiotherapy and chemotherapy(DP group).The control group were given PF concurrent radiotherapy and chemotherapy(PF group).Chemotherapy was given in the first and the fifth week of radiotherapy,respectively.The clinical efficacy and adverse reactions of radiotherapy and chemotherapy were compared between the two groups.Results The recent total effective rate of the study group was 83.0%,higher than that(63.8%)of the control group(P<0.05).The 1-year and 3-year survival rates of the study group and the control group were 78.72%and 46.81%,65.96%and 27.66%,respectively.The median survival time of the study group(28.0 months)was significantly longer than that of the control group(18.3 months),difference was statistically significant(P<0.05).There was no statistically significant difference between the two groups in gastrointestinal reaction,hematotoxicity,radiation esophagitis,radiation pneumonia and other incidence rates(P>0.05).Conclusion Compared with PF chemotherapy,concurrent IMRT with DP chemotherapy can improve the short-term efficacy of patients,significantly improve 1-year and 3-year survival rates,prolong median survival time without significant increase in toxic and side effects,which is worthy of recommendation.