放疗联合周剂量奈达铂治疗老年食管癌的临床研究

探讨放疗联合周剂量奈达铂治疗老年食管鳞癌患者的疗效及毒性。方法:选取49例老年食管癌患者，随机分为奈达铂每周化疗同步放疗（同步组）24例和单纯放射治疗（单放组）25例，两组放疗均采用常规分割，照射剂量60～66 Gy。同步组奈达铂30 mg/m2，每周1次，连续6周。结果:同步组完全缓解10例，部分缓解11例，有效率87.5%，单放组完全缓解4例，部分缓解11例，有效率60.0%，两组比较差异有统计学意义（P<0.05）。同步组2～3度白细胞下降占54.2%，明显高于单放组的20.0%（P<0.05），同步组3度血小板下降3例，单放组无3度血小板下降病例。两组2～3度放射性食管炎发生率差异无统计学意义（37.5% vs 32.0%）。结论:奈达铂每周化疗同步放疗治疗老年食管癌近期疗效较好，骨髓抑制稍加重但可耐受。 

Effects of Weekly Dose of Nedaplatin Combined with Radiation on Elderly Patients with Esophageal Carcinoma

To evaluate the efficacy and toxicity of the weekly dose of Nedaplatin combined with radiation for esophageal squamous cell carcinoma in elderly patients. Methods: Forty-nine patients were randomly divided into two groups to receive either radiotherapy only ( Group 1, 25 cases ) or weekly dose of Nedaplatin combined with radiotherapy ( Group 2, 24 cases ). Patients in both groups received conventional radiotherapy with a total dose of 60 Gy to 66 Gy. In Group 2 30 mg/m2 of Nedaplatin was administered once a week for six successive weeks starting from the first day of radiotherapy. Results: Among the 24 patients in Group 2, 10 patients achieved CR ( 41.7% ), 11 PR ( 45.8% ), and the reponse rate ( CR plus PR ) was 87.5%. On the other hand, in Group 1, 4 patients achieved CR (16.0%), 11 PR ( 44.0% ), and the response rate ( CR plus PR ) was 60.0% ( P < 0.05 ). The occurrence rate of G2/3 toxicity of leukopenia in Group 2 was 54.2%, which was obviously higher than that in Group 1 ( P < 0.05 ). The occurrence rates of G2/3 toxicity of radiation esophagitis between the two groups did not have statistical differences. Conclusion: Weekly dose of Nedaplatin combined with radiotherapy can effectively treat esophageal cancer in elderly patients.