放疗同步应用奈达铂治疗中晚期食管癌的临床观察

目的：探讨放疗同步奈达铂单药化疗治疗中晚期食管癌的疗效和毒副反应。方法：２００７年４月～２００８年３月共３６例中晚期食管癌患者入组，采用６ＭＶ-Ｘ线常规放疗，每天１次，每次２Ｇｙ，每周照射５次，总量６０～６５Ｇｙ。于放疗之日起即给予奈达铂３０ｍｇ／次，每周１次，共６次，治疗结束后１个月评价近期疗效和毒副反应。结果：３６例患者中，ＣＲ６例（１６.７％），ＰＲ２４例（６６.７％），ＮＣ５例（１３.８％），ＰＤ１例（２.８％），有效率（ＣＲ＋ＰＲ）为８３.４％。毒副反应主要为骨髓抑制、消化道反应，但均可以耐受。结论：放疗同步奈达铂单药化疗治疗中晚期食管癌疗效较好，毒副反应可以耐受，值得进一步推广应用。

Clinical observation for radiotherapy concurrently combining with nedaplatin in the treatment of advanced esophageal carcinoma

Objective ： To explore curative and side effects of sensibilization chemotherapy of radiotherapy concurrently combi- ning with nedaplatiu in the treatment of advanced esophageal carcinoma. Methods：Between April 2007 and March 2008, 36 advanced esophageal carcinoma patients received conventional radiotheraphy using 6MV X-ray with the dose of 2Gy once a day, 5 times per week, total dose was 66 -65Gy. From the day of radiotherapy, 30rag nedaplatin was administered once a week, and total dose reached 180rag/6 times when radiotherapy completed. Hemogram was tested eve17 week during the therapy, and immediate curative and side effects were evaluated in one month after the therapy based on the esophagram between pre and post treatment, hemogram, hepatic and renal function, and digestive tract symptom etc. Results： Among 36 patients, 6 achieved CR（ 16. 7% ）, 24 PR（66. 7% ）, 5 NC （ 13.8% ）, 1 PD（2.8% ）, and response rate（ CR plus PR） was 83.4%. Symptoms such as obstruction, retrosternal pain, etc, were improved at different degree after radiochemotherapy. Side effects were mainly about myelosuppression and digestive tract reaction, and were improved after symptomatic supportive treatments. Conclusion：Sensibilization chemotherapy of radiotherapy concurrently combing with nedaplatin, with well tolerated side effects, has a good effect on advanced esophageal carcinoma and is worth further widely using.