多西他赛联合顺铂同步放化疗和单纯放疗治疗老年非手术食管鳞癌的临床疗效分析

Clinical Efficacy Analysis of Docetaxel Combined with Cisplatin Concurrent Chemoradiotherapy and Radiotherapy Alone in the Treatment of Senile Non-operative Esophageal Squamous Cell Carcinoma

目的评估多西他赛联合顺铂同步放化疗对比单纯放疗在治疗老年(≥65岁,≤75岁)非手术食管鳞癌的近远期疗效及安全性。方法回顾性分析97例老年非手术食管鳞癌患者,其中多西他赛(DTX)联合顺铂(DDP)同步放化疗组50例,单纯放疗组47例。两组均采用三维适形放射治疗或调强放射治疗,放疗剂量:50～60 Gy,2 Gy/次/天,每周5次,化疗:DTX 25 mg/m^2+DDP 25 mg/m^2d1、d8、d15、d22、d29。比较两组患者近期疗效、不良反应及远期生存率。结果同步放化疗组治疗有效率(完全缓解+部分缓解)为80%,单纯放疗组有效率为57%,差异具有统计学意义(P=0. 027)。同步放化疗组1、3、5年生存率为:84%、27%、19%,单纯放疗组为:71%、13%、7%,差异均具有统计学意义(P<0. 05)。两组不良反应均可耐受。结论多西他赛联合顺铂同步放化疗可提高老年非手术食管鳞癌患者近期疗效和远期生存率,且不良反应可耐受。

Objective To compare the efficacy and safety of docetaxel and cisplatin based concurrent chemoradiotherapy( CRT) with radiotherapy( RT) alone in non-surgical elderly( ≥65 岁,≤75 岁) patients with esophageal squamous cell carcinoma( ESCC). Methods A total of 97 elderly patients with ESCC were included in the present study. Among them,50 patients received docetaxel( 25 mg/m^2,days,1,8,15,22,29) and cisplatin( 25 mg/m^2,days,1,8,15,22,29) based CRT and 47 patients received RT( 50 ~ 60 Gy/25 ~ 30 F/5 ~ 6 W) lone. Results The recent effective rate in the CRT group( 80%) was significantly higher than in the RT group( 57%),the difference was statistically significant( P = 0. 027). The 1-year,3-year and 5-year overall survival( 84%,27%,19%,respectively) in the CRT group were significantly higher than that in the RT group( 71%,13%,7%,respectively). The toxic and side effect were tolerable in the two groups. Conclusion CRT with docetaxel and cisplatin can improve recent effective rate and overall survival compared with tolerable toxic reactions in the elderly ESCC patients.