局部晚期食管鳞癌诱导化疗联合大分割放疗的近期疗效分析

目的:探讨采用诱导化疗联合大分割模式治疗食管癌的急性反应和近期疗效.方法:将符合入组条件的33例食管鳞癌患者先行多西他赛和顺铂诱导化疗2个周期,然后进行适形放射治疗,其中每次肿瘤区域的剂量为2.5 Gy,临床靶区的剂量为2 Gy;5次/周,共26次.结果:治疗结束时全组患者总有效率为93.9％(31/33),其中完全缓解(CR)率为60.6％(20/33),部分缓解(PR)率为33.3％(11/33).1和2年生存率分别为83.0％和51.1％.30.3％(10/33)的患者出现3级白细胞计数降低,t5.2％(5/33)的患者出现3级急性放射性食管炎,均无4级急性反应.9.1％(3/33)的患者治疗后出现食管狭窄,需行食管扩张术.未发现放射性肺炎.结论:采用大分割放射治疗联合诱导化疗治疗局部晚期食管鳞癌是安全的,能提高部分患者的局部控制率和生存率,且急性反应小.

Analysis of the short term effect of hypofractionated radiotherapy combined with induction chemotherapy for advanced esophageal squamous cell carcinoma

OBJECTIVE:To investigate the acute toxicities and short-term effect of hypofractionated radiotherapy combined with induction chemotherapy for advanced esophageal squamous cell carcinoma.METHODS:Thirty-three patients with advanced esophageal squamous cell carcinoma received the induction chemotherapy for two cycles using docetaxel and cisplatin followed by conformal radiation therapy.The prescribed dose to gross tumor volume was 2.5 Gy,and the clinical target volume was 2 Gy,total 26 orders.RESULTS:The overall response rate was 93.9%(31/33),while the complete reaponse rate and the partial response rate were 60.6%(20/33) and 33.3%(11/33).The 1-year survival and the 2-year survival were 83.0% and 51.1%.The grade 3 of leucocytopenia occurred in 30.3%(10/33).The grade 3 of acute radiation esophagitis occurred in 15.2%(5/33).There were 9.1%(3/33) patients with esophageal stenosis needed bougienage of oesophagus.No patient had radiation pneumonitis.CONCLUSION:Hypofractionated radiotherapy combined with induction chemotherapy for advanced esophageal squamous cell carcinoma is safe.It can improve the local control and survival rate,and the acute toxicities are little.