三维适形放疗同步TP方案治疗中晚期食管癌的临床研究

目的 观察三维适形放疗同步TP方案治疗中晚期食管癌的临床疗效及安全性.方法 将本院收治的80例中晚期食管癌患者随机分为同步放化疗组和单纯放疗组,每组40例.同步放化疗组给予紫杉醇＋奈达铂化疗（TP化疗）同步三维适形放疗,单纯放疗组仅给予三维适形放疗.比较两组临床疗效,1、2、3年生存率及毒副反应发生情况.结果 同步放化疗组临床有效率及2年生存率明显高于单纯放疗组,且1、3年生存率有高于单纯放疗组的趋势,但差异无统计学意义（P＞0.05）.同步放化疗组白细胞减少、血小板减少及消化道反应发生率均显著高于单纯放疗组,但经积极对症支持治疗后患者均能耐受并完成治疗.结论 三维适形放疗同步TP化疗治疗中晚期食管癌在降低肿瘤局部复发率、提高患者远期生存率方面具有一定优越性,且毒副反应患者可耐受.

Clinical Study on Three Dimensional Conformal Radiotherapy Combined with TP Regimen in the Treatment of Middle to Advanced Esophageal Cancer

Objective To observe the efficacy and safety of three dimensional conformal radiotherapy （3- DCRT） combined with TP regimen in the treatment of middle-advanced esophageal cancer. Methods Eighty patients with middle-advanced esophageal cancer were randomly divided into two groups, 40 cases in each group.Concurrent chemoradiotherapy group was given taxol＋ nedaplatin chemotherapy （TP chemotherapy） combined with 3-DCRT, while the simple radiotherapy group was only given 3-DCRT. The clinical efficacy, 1, 2 and 3-year survival rates as well as toxic reactions were compared in both groups. Results The response rate and 2-year survival rate in concurrent ehemoradiotherapy group were significantly higher than in simple radiotherapy group, and 1 and 3-year survival rates were slightly higher, but without statistical significance. The incidences of leucopenia, thrombocytopenia and gastrointestinal reactions in concurrent ehemoradiotherapy group were markedly higher than in simple radiotherapy group, which could be tolerated by all the patients after being given corresponding symptomatic treatments. Conclusion For middle to advanced esophageal cancer, 3-DCRT combined with TP regimen chemoradiotherapy has a certain superiority in terms of decreasing local recurrence rate and improving long- term survival rate, and the toxic reactions can be tolerated by patients.