每周低剂量奈达铂同步放化疗治疗老年性局部中晚期食管癌

目的观察每周低剂量奈达铂(nedaplatin,NDP)同步放化疗治疗老年性局部中晚期食管癌的疗效和毒性。方法将62例老年性局部中晚期食管癌患者随机分为治疗组(30例)和对照组(32例)。两组患者均为常规放疗,总剂量60～65 Gy。治疗组在放疗同时使用低剂量NDP 25 mg/m2,1/周,连续用药5-7周。结果治疗组和对照组总有效率(CR+PR)分别为83.3%(25/30)和53.1%(17/32),两组比较差异有统计学意义(χ2=6.46,P<0.05)。1年生存率治疗组为76.7%(23/30),对照组为59.4%(19/32),两组比较差异无统计学意义(χ2=2.12,P>0.05);2年生存率治疗组为43.3%(13/30),对照组为15.6%(5/32),两组比较差异有统计学意义(χ2=5.76,P<0.05)。3年生存率治疗组为36.7%(11/30),对照组为12.5%(4/32),两组比较差异有统计学意义(χ2=4.93,P<0.05)。治疗组的放化疗毒性以白细胞减少和血小板减少多见,未出现Ⅳ级骨髓抑制,骨髓抑制发生率46.7%(14/30),稍高于对照组28.1%(9/32),但差异无统计学意义(χ2=2.28,P>0.05)。结论每周低剂量奈达铂同步放化疗治疗局部中晚期老年食管癌的疗效显著,不良反应小,值得临床进一步研究。

Concomitant radiochemotherapy with nedaplatin in elderly patients with locally middle-advanced stage esophageal carcinoma

Objective To evaluate the efficacy and safety of concomitant ratiochemotherapy with nedaplatin（NDP） in elderly patients with local middle-advanced stage esophageal carcinoma.Methods Sixty-two elderly patients with middle-advanced stage esophageal carcinoma were randomized into trial（R＋C group,n=30） and control groups（R group,n=32）.Patients in both groups were treated by radiotherapy with a total dose of 60~65 Gy;and trial group received nedaplatin（25 mg/m2/w） simultaneously for 5-7 weeks.Results The overall response rate（CR＋PR） in the trial group and the control group was 83.3%（25/30） and 53.1%（17/32）,respectively（χ2=6.46,P0.05）.The 1-year survival rate in the trial group and the control group was 76.7%（23/30） and 59.4%（19/32）（χ2=2.12,P0.05）;2-years survival rate in two groups was 43.3%（13/30） and 15.6%（5/32）（χ2=5.76,P0.05）;3-years survival rate of two groups was 36.7%（11/30） and 12.5%（4/32）,respectively（χ2=4.93,P0.05）.The main toxicities were leukopenia and thrombocytopenia（gradeⅠ~Ⅲ） in two groups（46.7% vs 28.1%,χ2=2.28,P0.05）.Conclusion Nedaplatin（NDP） at weekly low dose concurrent with radiotherapy is effective and of less side effect in treatment of elderly patients with local middle-advanced stage esophageal carcinoma.