放疗联合卡培他滨或顺铂治疗局部晚期食管癌临床研究

目的 比较放疗联合卡培他滨与联合顺铂治疗局部晚期食管癌的疗效和毒副反应.方法 74例晚期食管癌患者随机分为两组,卡培他滨组(放疗联合卡培他滨)35例,于放疗开始时口服卡培他滨,500 mg/次,2次/d,至放疗结束；顺铂组(放疗联合顺铂)39例,于放疗开始第1天,每周静脉滴注顺铂20 mg/m2,共6次.分析比较两组疗效及毒副反应.结果 治疗结束后2个月时,卡培他滨组总有效率为91.4％,顺铂组总有效率为89.7％,两组差异无统计学意义(P＞0.05)；生存分析两组患者总生存率差异无统计学意义(P＞0.05)；卡培他滨组胃肠道反应、骨髓抑制及晚期放疗反应均较顺铂组轻(均P＜0.05).结论 卡培他滨联合放疗和顺铂联合放疗治疗局部晚期食管癌疗效相当,但卡培他滨联合放疗毒副反应较轻,治疗耐受性较好,值得临床推广.

Clinical study on radiotherapy combined with xeloda or carboplatin in the treatment of locally advanced esophagus carcinoma

Objective To evaluate the effects and toxic side-effects of radiotherapy combined with xeloda or carboplatin respectively for locally advanced esophagus carcinoma. Methods 74 cases with locally advanced esophagus carcinoma were randomly allocated into two groups. One group received radiotherapy combined with Xeloda, 500mg at a time ,twice a day ,taken orally from the beginning of radiotherapy till end of treatment. The second group received radiotherapy combined with Carboplatin by intravenous drip at 100mg a day,for 5 days,from the first week of radiotherapy. Results The overall response rate in the radiotherapy combined with Xeloda group was 91.4% and 89. 7% in the radiotherapy combined with Carboplatin group. The difference between the two groups was not statistically significant（ P 〉 0.05 ）. Kaplan-Meier survival analysis showed no statistically significant differences in survival between the two groups. The toxic side-effects of gastrointestinal tract, reaction myelosuppression and late radiation re- action were notably alleviated in the Xeloda group compared with the Carboplatin group. Conclusion Compared with Carboplatin, Xeloda combined with radiotherapy had less toxic side-effects for treatment of advanced esophagus carcinoma, with an equal local control rate ,which worthy of clinical application.