奥沙利铂联合替吉奥同步三维适形放疗治疗中晚期贲门癌的疗效观察

目的:探讨奥沙利铂联合替吉奥同步三维适形放疗治疗中晚期贲门癌的临床疗效及不良反应。方法:将我科收治的102例中晚期贲门癌患者，随机分为2组，同步放化疗组50例,单纯放疗组52例。单纯放疗组放疗采用（1.8-2.0）Gy/次，共（57.6-62.0）Gy/（5.8-7.0）周；同步放化疗组放疗同单纯放疗组，同时以奥沙利铂100mg/m2,静滴，第1天，替吉奥胶囊80mg/(d·m2)，分2次餐后口服，第1-14天，每28天一个周期，连续化疗3个周期。结果:同步放化疗组与单纯放疗组比较:CR分别为36.0%、11.5%，PR分别为54.0%、53.8%,SD分别为6.0%、17.3%，PD分别为4.0%、17.3%，RR分别为90.0%、65.4%,有显著性差异（χ2=8.884，P=0.003 ）。同步放化疗组与单纯放疗组1年生存率分别为58.0%、36.5%，2年生存率分别为36.0%、13.5%，3年生存率分别为22.0%、0，有显著性差异(χ2=10.131，P=0.001)。两组不良反应比较:同步放化疗组与单纯放疗组Ⅱ-Ⅳ度白细胞计数下降发生率分别为52.0%、46.2%,恶心、呕吐发生率分别为18.0%、9.6%，两者无显著性差异（P均＞0.05）。结论:奥沙利铂联合替吉奥同步三维适形放疗治疗中晚期贲门癌较单纯放疗疗效好，不良反应能耐受。

Efficacy of oxaliplatin combined with S-1 concurrent three-dimensional conformal radiotherapy in the treatment of advanced cardia cancer

Objective:To investigate the clinical efficacy and adverse reactions of oxaliplatin combined with S-1 concurrent three dimensional conformal radiotherapy for advanced cardia cancer.Methods:All 102 cases of advanced cardia cancer were treated in our department,randomly divided into 2 groups,concurrent chemoradiotherapy group 50 cases,radiotherapy group 52 cases.Chemoradiotherapy group were treated by (1.8-2.0)Gy/f,(57.6-62.0)Gy/(5.8-7.0)w,at the same period oxaliplatin 100mg/m2,intravenous drip,first day,S-1 capsule 80mg/(d·m2),2 times oral administration,the 1-14 days,every 28 days for a cycle,3 cycles of chemotherapy were given.Results:In chemoradiotherapy group,radiotherapy group:CR were 36.0%,11.5%,PR were 54.0%,53.8%，SD were 6.0%,17.3%，PD were 4.0%,17.3%，RR were 90.0%,65.4%,there was significant difference between two groups(P=0.003).Concurrent chemotherapy and radiotherapy 1 year survival rates were 58.0%,36.5%,2 years survival rates were 36.0%,13.5%,3 years survival rates were 22.0% and 0,there was significant difference between two groups(P=0.001).Comparison of adverse reaction between two groups:Concurrent chemoradiotherapy group of adverse reaction than radiotherapy group,Ⅱ-Ⅳ degree decreased leucocyte were 52.0%,46.2%,nausea,vomiting incidence were 18.0%,9.6%(P＞0.05).Conclusion:Oxaliplatin combined with S-1 synchronous effect of three dimensional conformal radiotherapy in treatment of advanced cardia cancer is effective and better than radiotherapy alone,the toxicity is tolerable.