雷替曲塞与PF方案同步放疗治疗食管癌的疗效比较

目的比较雷替曲塞同步放疗与5-氟尿嘧啶联合顺铂(PF方案)同步放疗治疗Ⅱ~Ⅲ期食管癌的近期疗效及及不良反应。方法选择2018年1月至2019年4月Ⅱ~Ⅲ期食管癌患者79例,均采用食管病灶区适形调强放射治疗(DT=60 Gy/30f),按随机数字表法分为雷替曲塞同步放疗组(观察组,n=39)和PF方案同步放疗组(对照组,n=40)。比较两组总有效率、1年生存率及毒副反应等方面的差异。结果观察组总有效率、1年生存率均高于对照组(89.74%vs 80.00%,P=0.228;84.62%vs 80.00%,P=0.591),两组差异无统计学意义(P>0.05)。在治疗结束后3个月,观察组鳞癌相关抗原(SCC)含量及细胞角蛋白片段19(CYFRA21-1)含量显著降低,生活质量评分改善明显优于对照组,差异均有统计学意义(P<0.05)。观察组消化道反应、放射性食管炎及白细胞下降发生率均小于对照组(P<0.05)。血小板下降及肾功能损害发生率两组差异无统计学意义(P>0.05)。观察组肝功能损害发生率高于对照组(P<0.05)。结论在Ⅱ~Ⅲ期食管癌治疗中,雷替曲塞同步放疗与PF方案近期疗效相当,安全性更好,是临床中治疗中晚期食管癌的一种更为有效的方法。

Objective To investigate the short-term clinical eficacy and adverse effects of raltitrexed compare with PF(5-Fluorouracil plus Cisplatin)regimen in concurent chemoradiotherapy in the treatment of stageⅡ~Ⅲesophageal cancer.Methods A total of 79 patients with stageⅡ~Ⅲesophageal carcinoma in our hospital(frorm January 2018 to April 2019)were sleted as subjects of this study.All patients were treated with 3DCRT at a total dose of 60 Gy/30 f They were randomly distributed to the ralitrexed radiotherapy group(experimental group,n=39)and to the PF regimen radiotherapy group(control group,n=40)。The total effective rate,l-year overall survival rate and adverse efects of the two groups were compared.Results The total ffective rate,1-year overall survival rate of the experimental group were higher than those of the control group[89.74%vs 80.00%,P=0.228;84.62%vs 80.00%,P=0.591],but the difference was not stitically significant(P>0.05).The SCC(Squamous carcinoma associated antigen)content and the CYFRA21-1(Cytokeratin fragment 19)content of the experimental group was significantly lower and the improvement of quality of life score was significantly better than that of the control group at 3 months after treatment(P<0.05).The incidence rates of gastrointestinal response,radiation-induced esophagitis and leucocytopenia were significantly lower in the experimental group than in the control group(P<0.05).The incidence rates of thrombocytopenia and renal dysfunction of the two groups were similar(P>0.05).The incidence rate of hepatic dysfunction was significantly higher than that of the control group(P<0.05).Conclusion To the PF regimen radiotherapy,the raltrexed radiotherapy achieves a similar short-term cinical eficacy but lower adverse effects on patients with stageⅡ~Ⅲesophageal cancer.So the raltitrexed radiotherapy is a more effective method in concurrent chemoradiotherapy for stageⅡ~Ⅲesophageal cancer.