晚期食管癌放射治疗合并力尔凡的临床观察

Combination of External Radiotherapy and LIFEIN in the Treatment of Esop hagus Cancer

目的:观察放疗配合链球菌制剂(力尔凡)治疗食管癌的疗效,免疫功能及放射反应的变化。方法:对符合入组条件的118例食管癌患者随机分为综合组和常规放疗组。常规放疗组60例(对照组),食管癌常规外照射总量DT60～64Gy/6～7周,每次2Gy,每周5次。均采用8MVX线照射;综合组56例,外照射合并力尔凡,外照射同常规放疗组。力尔凡给药方案:放疗d1～3给予5mg/天皮下注射,连用3天;d4起10mg/天静脉滴注,连用30～45天与放疗同步。结果:全部患者随访2年以上,随访率99.1%。1)完全缓解率综合组和常规放疗组分别为44.64%和30.0%(χ2=4.35,P=0.0382),2年生存率分别为46.43%和31.67%,(χ2=4.47,P=0.0344),差异有显著性。2)综合组均如期完成放疗。放疗期间血常规低于正常范围者2例,对照组有11例血常规低于正常范围,放疗周期延长3～10天。3)放射性食管炎、气管炎的发生率综合组少于对照组,但差异无显著性。4)治疗后综合组T3、T4、T4/T8、NK细胞活性明显高于对照组,P<0.01。结论:食管癌放疗合并力尔凡疗效优于单纯放疗,同时能明显减轻放疗不良反应和提高患者的免疫功能。

Objective:To evaluate th e effect of Esophageal cancer and the change of the radiation reaction and immun e function by External radiotherapy combine LIFEIN.Methods:116cases of esop hageal cancer were randomly allocated into two groups.synthesis group(SG):r outine radiotherapy same the conventional fractionation group.Lifein begins5m g/day continues3days i.h.pro-radiotherapy,then10mg/day ivgtt continue s3045days combine radiotherapy;the conven-tional fractionation group(CF )received routine radiotherapy2Gy per day,5times a week to a total dose of 60～64Gy in6～7weeks.Results:All patients were followed at more then tw o years.The follow-up rate was99.1%.(1)The CR:SG and CF in separate were44.64%and30.0%( 2 =4.35P=0.0382),The survival rate of2-year of SG and CF leave each other were:46.43%and31.67%,( 2 =4.47P=0.0344)?The survival rate of SG group is better than CF group.Between the two groups,there was significant difference in the surviv al rate of2-year.(2)SG group accom-plished the radiotherapy was on schedu le of all patients;CF group have11case delay the radio-therapy310days f or white cell lower4.0×10 9/mm 3 .(3)Radioactivity esophageal inflammation and radioactivity Inflammation of the trachea of SG group is lower than CF group,but there was no difference with statistical analysis.(4)After treatment the T cell subgroup T 3 ,T 4 ,T 4/T 8 and NK of SG group is significant better than CF group,P<0.01.Conclu sion:The results from this study showed that the SG group sur vival rateofe sophageal canceritis better than conven tiona lradio-therapy,and atoneti meitcanno tably tomitiga tetheradia tionreactionandim prove the cellimmune function of the patients.