三维适形放射治疗联合替吉奥治疗老年食管癌的临床观察

目的：研究三维适形放射治疗联合替吉奥治疗老年食管癌的疗效及不良反应.方法：78例老年食管癌患者随机分为放疗组40例和放化组38例,两组均采用三维适形放射治疗.放化组于放疗的当天口服替吉奥50mg,2次/天,与放疗同步,服4周,休2周,直到放疗结束.结果：放疗结束后1月放疗组和放化组获完全缓解分别为22.5％ （9/40）和44.7％（17/38）,有效率分别为70.0％ （28/40）和89.5％ （34/38） （P=0.033）.放化组和放疗组的1、2年生存率分别为81.6％（31/38）、57.5％ （23/40） （P =0.021）和57.9％（22/38）、35.0％ （14/40） （P =0.043）.放化组的严重急性不良反应高于单纯放疗组,Ⅱ级以上分别为43.9％和30.8％,差异无显著性意义（P =0.054）.结论：三维适形放射治疗联合替吉奥可以提高老年食管癌的近期疗效,不良反应轻,患者可以耐受.

Clinical study of S-1 and 3-demensional conformal radiotherapy for old patients with esophageal cancer

Objective： To study the efficacy and adverse effects of S - 1 combined with radiotherapy in old patients with esophageal cancer. Methods：Total of 78 old patients with esophageal cancer were randomized into two groups ：40 patients treated by radiotherapy alone and the other 38 patients treated by chemoradiotherapy. The schedules of radio- therapy in two groups were 3D - CRT in conventional fractionation, total dose 60Gy for all patients. Chemoradiotherapy group received S - 1 treatment by 50mg bid, since the first day of radiotherapy with chemotherapy simultaneously, and administration for 4 weeks followed by a 2 - week rest until the end of the radiotherapy treatment. Results： In the pa- tients of single radiotherapy group, the rates of complete response and total response were 9 cases and 70% respective- ly. In the patients of combined group, they were 17 cases and 89.5 % respectively （P = 0. 033 ）. The survival rates at 1 - and 2 - year were 81.6% and 57.5% in the concurrent chemoradiotherapy group （ P = 0.021 ） , 57.9% and 35.0% in the radiotherapy alone group（ P = 0.043 ）. The acute toxicity rate was 43.9% in concurrent chemoradio- therapy group and 30.8% in radiotherapy alone group（P = 0.054）. Conclusion： Concurrent chemoradiotherapy with S - 1 can effectively treat old patients with esophageal cancer, and acute toxicity are tolerable.