放疗同步联合替吉奥治疗老年食管癌的临床观察

目的 探讨放疗同步联合替吉奥治疗老年食管癌的疗效和毒副反应。方法 将60例老年食管癌患者随机分为对照组和试验组各30例。两组均采用调强放射治疗，处方剂量为DT 56～64Gy／28～32f。试验组于放疗第1天联合替吉奥同步化疗，具体为：替吉奥60mg／m2，分早、晚餐后两次服用，d1～d14，21天为1周期，共2个周期。结果 60例患者均可评价疗效。试验组获CR 15例、PR 10例、SD 4例、PD 1例，RR为83.3％；对照组获CR 10例、PR 8例、SD 8例、PD 4例，RR为60.0％。两组RR比较差异有统计学意义（P=0.045）。试验组的1、2年生存率分别为76.7％和56.7％， 对照组分别为53.3％和30.0％（P=0.049）。两组毒副反应均以1～2级为主，主要表现为消化道反应、血液学毒性和放射性食管炎及肺炎，两组比较差异无统计学意义（P＞0.05）。结论老年食管癌患者采用放疗联合替吉奥同步化疗，疗效显著，耐受性好，口服给药方便，值得临床推广。

Clinical observation of radiotherapy combined with S-1 for elder patients with esophageal cancer

Objective To investigate the efficacy and side effects of radiotherapy combined with S-1 for elder patients with e- sophageal cancer. Methods Sixty elder patients with esophageal cancer were randomly divided into control group and experimental group with thirty cases in each group. Intensity-modulated radiotherapy was applied in the two groups with a total dose of DT 56-64Gy/ 28-32f. Patients in the experimental group received S-I chemotherapy concurrent with the radiotherapy on the first day. S-1 was orally given 60mg/m2 daily after meals from dI to dl4 with 21days as a cycle for 2 cycles. Results The efficacy of the 60 patients could be evaluated. In experimental group, CR was in 15 cases, PR in 10 cases, SD in 4 cases and PD in 1 case, and the effective rate was 83.3%. While those of control group were 10, 8, 8 and 4 cases, and the effective rate was 60.0%. The effective rates of the two groups had statistic significance（ P = 0. 045 ）. The 1-, 2-year survival rates of experimental group were 76. 7% and 56.7% , and those of control group were 53.3% and 30. 0% （P = 0. 049）. The major adverse effects in the two groups were myelosuppression, digestive tract reaction, radiation esophagitis and radiation pneumonitis, mainly in grade 1-2. The adverse effects between the two groups showed no difference （ P 〉 0. 05 ）. Conclusion Radiotherapy combined with S-1 for elder patients with esophageal cancer is a tbasible regimen with tolerable adverse effects and convenient administration, worth clinical application.