华蟾素配合立体定向放射治疗中晚期食管癌28例

目的观察华蟾素配合立体定向伽玛射线放射治疗中晚期食管癌的近期临床疗效。方法将56例患者随机均分为华蟾素联合伽玛刀治疗组（治疗组）和伽玛刀单独治疗组（对照组）。伽玛刀治疗总剂量40～50Gy,次数10～12次,边缘剂量300～420cGy,等剂量曲线55%～85%,每日治疗1次;治疗组加用华蟾素注射液20～30mL静脉滴注,1次/d,连续3～4周。结果 56例患者均顺利完成治疗,治疗组梗阻症状总缓解率、影像学总缓解率均显著高于对照组（P均小于0.05）;治疗组不良反应如急性放射性食管炎、白细胞下降发生率虽低于对照组,但差异无统计学意义（P〉0.05）。结论华蟾素注射液联合伽玛射线立体定向放射治疗中晚期食管癌患者,临床症状缓解率高,毒副作用小,患者耐受性好,近期疗效令人满意。

Stereotactic Radiotherapy Combined with Cinobufotoxin for Treating Advanced Esophagus Carcinoma in 28 Cases

Objective To observe the short-term clinical effects of advanced esophagus carcinoma treated by gamma-knife stereotactic radiotherapy combined with cinobufotoxin injection.Methods 56 cases of advanced esophagus carcinoma were randomly divided into two groups （28 cases for each group）.The treatment group was treated by gamma-knife stereotactic radiotherapy combined with cinobufotoxin injection,while the control group received single gamma-knife stereotactic radiotherapy.Gamma-knife treatment was conducted with a total dosage of 40-50 Gy （10-12 fractions） at 55%-85%equivalent dose curves,edge dosage was 300-420 cGy and 20-30 mL of cinobufotoxin injection was given daily by intravenous infusion for 3-4 weeks.Results All patients completed the therapy,the remission rate of both obstruction symptoms and radiological examination was markedly improved in the treatment group than in the control group（P〉0.05）;the incidence of side-effects such as acute radiation-induced esophagitis and leukocyte decrease was lower in the treatment group than in the control group,but the differences had no significance（P〉0.05）.Conclusion The treatment of advanced esophagus carcinoma with gamma-knife stereotactic radiotherapy and cinobufotoxin injection has satisfactory short-term clinical effects.The remission rate is promoted,the incidence of side-effects is low and the tolerance of patients is good.