甘氨双唑钠对食管癌根治性放疗后复发再程放疗的增敏作用

目的:观察甘氨双唑钠(CMNa)对食管癌根治性放疗后复发再程放疗的放射增敏作用及不良反应. 方法:2001-07/2003-06,收治食管癌放疗后局部复发行再程放疗的患者46例,均为首程放疗结束后疗效达到基本痊愈或明显缓解者,一段时间后又出现吞咽情况恶化等临床症状,经病理检查确诊为复发,随机分为研究组和单放组,每组23例,研究组:CMNa 800 mg/m2,用生理盐水100 mL稀释溶解后静脉输入,输入结束后60 min内进行放射治疗,3次/wk,从再程放疗开始连续用药至放疗结束. 两组患者均采用加速器6MV-X线,体外等中心常规放疗或三维适形放疗,每次2 Gy, 5次/wk,照射剂量50～66 Gy. 对比两组近期疗效、局部控制率、生存率及毒副反应差别. 进行X线和CT检查客观评价. 结果:研究组近期有效率(CR PR) 73.9%,单放组为43.5% (P＜0.05). 两组的1,2,3 a局控率分别为65.2%,39.1%,30.4%和43.5%,17.4%,8.7%(P＜0.05);1,2,3 a生存率分别为87.0%,47.8%,34.8%和69.6%,21. 7%,13.0%(P＜0.05). 结论:CMNa可以增加食管癌放疗后复发病灶的放射敏感性,放疗合并使用CMNa可提高食管癌根治性放疗后复发的近期疗效、局部控制率及生存率.

Sensitivity enhancement of sodium glycididazole in re-radiotherapy against local recurrent esophageal carcinoma after radical radiotherapy

AIM: To investigate the sensitivity enhancement of sodium glycididazole (CMNa) in re-radiotherapy against local recurrent esophageal carcinoma after radical radiotherapy. METHODS: Such cases (n=46) who recurred after they had received radical radiotherapy and were confirmed by pathology from July, 2001 to June, 2003 were divided randomly into study group and control group. Before re-radiotherapy, the patients in study group were treated by intravenous infusion of CMNa 800 mg/m2 diluted in 100 mL sodium chloride, 3 fractions a week through the total therapy course. The radiotherapy was carried out 60 min after each infusion. All patients received conventional radiotherapy or three dimensional conformal radiotherapy at 2.0 Gy each time, 5 fractions a week to a total dose of 50-60 Gy. The short-term therapeutic effect, local control rate, survival rate and side effects were compared in the 2 groups. CT and barium meal examinations of esophagus were performed. RESULTS: The short-term effective rates (CR+PR) were 73.9% in study group, 43.5% in control group (P<0.05). The 1-, 2- and 3-year local control rates were 65.2%, 39.1% and 30.4% in study group, 43.5%, 17.4%, and 8.7% in control group (P<0.05). The 1-, 2- and 3-year survival rates were 87.0%, 47.8% and 34.8% in study group, 69.6%, 21.7% and 13.0% in control group (P<0.05). The incidence rates were not found different among the 2 groups. CONCLUSION: CMNa can enhance the radiosensitization of the local recurrent esophageal carcinoma cells. Re-radiotherapy combined with CMNa can improve the short-term effective rates, local control rate and survival rate of the patients with local-recurrent esophageal carcinoma after radical radiotherapy.