适形调强放疗联合XELOX同步化疗治疗晚期食管癌疗效观察

目的探讨适形调强放疗联合奥沙利铂+卡培他滨(XELOX)同步化疗治疗晚期食管癌的临床疗效。方法选取2012年1月至2013年12月于该院接受治疗的120例晚期食管癌患者作为研究对象,随机分为对照组(60例)和观察组(60例)。对照组患者给予适形调强放疗,观察组在对照组基础上给予XELOX同步化疗。疗程结束后,比较对照组和观察组患者近期疗效、远期疗效、血清血管内皮生长因子(VEGF)水平及毒副反应发生情况。结果疗效评价后显示,观察组近期总有效率(81.7%)明显高于对照组(63.3%),组间比较差异有统计学意义(P0.05)。远期疗效方面,观察组患者1年生存率(66.7%)、2年生存率(50.0%)明显高于对照组(48.3%,31.7%),差异均有统计学意义(P0.05)。治疗后与对照组血清VEGF水平[(457.8±54.9)ng/L]相比,观察组患者血清VEGF水平[(401.2±50.4)ng/L]明显降低,差异有统计学意义(P0.05)。治疗期间,观察组和对照组患者Ⅰ~Ⅱ度、Ⅲ~Ⅳ度放射性食管炎、放射性肺炎、胃肠道反应、骨髓抑制等毒副反应发生率组间比较差异无统计学意义(P0.05)。结论适形调强放疗联合XELOX同步化疗治疗晚期食管癌疗效可靠,能够提高晚期食管癌的近期和远期疗效,明显降低血清VEGF水平,且不增加毒副反应发生率,值得临床进一步研究。

Curative efficacy of intensity modulated radiation therapy in combination with XELOX program in patients with advanced esophageal cancer

Objective To investigate the curative efficacy of intensity modulated radiation therapy in combination with oxalipla‐tin+capecitabine(XELOX) program in patients with advanced esophageal cancer .Methods Totally 120 patients of advanced e‐sophageal cancer who received therapy in our hospital from January 2012 to December 2013 were collected as research objects and divided into the control group(n=60) and the observation group(n=60) .The control group was given intensity modulated radia‐tion therapy .Besides that ,the observation group was given XELOX program additionally .Then ,the short‐term ,long‐term curative efficacy ,levels of serum vascular endothelial growth factor (VEGF) and toxic side effects between the two groups were compared . Results After the course of treatment ,the short‐term curative efficacy ratio in the observation group was 81 .7% ,which was statis‐tically higher than that of 63 .3% in the control group(P<0 .05) .As to long‐term curative efficacy ,the one‐year survival rate and two‐year survival rate in the observation group was statistically higher than the control group respectively (66 .7% vs .48 .3% , 50 .0% vs .31 .7% ,both P<0 .05) .After the treatments ,level of serum VEGF in the observation group was statistically lower than that in the control group[(401 .2 ± 50 .4) ng/L vs .(457 .8 ± 54 .9) ng/L ,P<0 .05] .During the treatments ,the incidences ofⅠ - Ⅱdegree ,Ⅲ - Ⅳ degree of radiation esophagitis ,radiation pneumonitis ,gastrointestinal reaction and myelosuppression in the two groups had no statistical significance(P> 0 .05) .Conclusion Intensity modulated radiation therapy in combination with XELOX program is effective for advanced esophageal cancer ,which can significantly increase short‐term ,long‐term curative efficacy and re‐duce level of serum VEGF without increasing incidence of toxic side effects .