调强放疗同步紫杉醇方案化疗治疗食管鳞癌近期疗效观察

目的:观察调强放疗同步紫杉醇+顺铂方案化疗治疗食管鳞癌的近期疗效及治疗相关不良反应。方法:我院2010年6月-2013年7月收治的70例初治食管鳞癌患者，分为放化疗组36例和单放组34例。单放组:放疗剂量为DT （60-66）Gy/（30-32）f；放化疗组:放疗开始给予紫杉醇135mg/m2，第1天，顺铂25mg/m2，第1-3天，21天为一个周期，共两个周期。放疗结束后3个月复查食管钡餐片及CT进行疗效评价。结果:放化疗组共36例食管鳞癌患者，治疗结束后3个月总有效率（response rate，RR)=(CP+PR）为91.7%，其中完全缓解率(complete response，CR)为55.6%、部分缓解率（partial response，PR）为36.1%、无缓解率（non-response,NR）为8.3%，总有效率高于单放组（73.5%），且差异有统计学意义（P＜0.05）。放化疗组1、2级不良反应发生率高于单放组，有统计学意义（P＜0.05），而3级以上不良反应及1、2级放射性肺炎两组无差异（P＞0.05）。结论:调强放疗联合紫杉醇+顺铂方案同步化疗治疗食管鳞癌近期疗效好，不良反应患者可耐受。

Short-term efficacy of intensity -modulated radiotherapy and concurrent paclitaxel chemotherapy for esophageal squamous cell carcinoma

Objective:To observe the short-term efficacy and adverse reactions of intensity-modulated radiotherapy and concurrent paclitaxel program chemotherapy for esophageal squamous cell carcinoma.Methods:From June 2010 to July 2013,70 previously untreated patients of esophageal squamous cell carcinoma were divided to two groups randomly:36 patients were treated by intensity-modulated radiotherapy and concurrent paclitaxel+cisplatin chemotherapy,and 34 patients treated by intensity-modulated radiotherapy only.Radiotherapy only group:Radiation dose were DT （60-66）Gy/（30-32）f;Chemo-radiotherapy group:Chemotherapy started with the radiotherapy,paclitaxel 135mg/m2,d1,cisplatin 25mg/m2，d1-3,21 days a cycle,for two cycles.To evaluate the effect by esophageal barium meal and CT 3 months after the radiotherapy.Results:In 36 patients of chemo-radiotherapy group,the overall response rate was 91.7%(CR+PR),and complete,partial,non-response rates were 55.6%,36.1%,8.3% respectively,the overall response rate was higher than radiotherapy group(73.5%),and the difference has statistical significance(P＜0.05).The adverse reactions of grade 1,2 in chemo-radiotherapy group were higher than radiotherapy group(P＜0.05),but adverse reactions of grade 3 or more and grade 1,2 of radiation-related pneumonitis were no significant difference between two groups(P＞0.05).Conclusion:The short-term efficacy of intensity-modulated radiotherapy and concurrent paclitaxel program chemotherapy for esophageal squamous cell carcinoma was better,and the adverse reactions could be tolerated.