甘氨双唑钠联合同期放化疗治疗局部中晚期食管癌的临床观察

目的 比较甘氨双唑钠（CMNa）联合同步放化疗（CRT）治疗局部中晚期食管癌的疗效和毒副反应。方法 2012年6月至2013年11月87例食管癌患者采用信封法随机分为CMNa+CRT组（n=44）和CRT组（n=43）。调强放疗采用6 MV直线加速器，2.0Gy/次，每周5次，DT 50Gy。CMNa+CRT组放疗前0～3h给予CMNa 800mg/m2静滴，每周1、3、5给药，直至放疗结束。化疗采用顺铂（DDP）+氟尿嘧啶（5-FU）方案：DDP 125mg/m2静滴，d1～d5；5-FU 450mg/m2静滴，d1～d5，28天为1周期， 共2个周期。结果 87例患者均可评价疗效。CMNa+CRT组获CR 31例，PR 8例，SD 4例，PD 1例，有效率为907%；CRT组获CR 25例，PR 7例，SD 9例，PD 2例，有效率为744%，两组有效率的差异有统计学意义（P=0043）。两组毒副反应主要为1～2级骨髓抑制、肝功能异常、放射性食管炎和放射性肺炎，差异无统计学意义（P＞0.05）。CMNa+CRT组和CRT组的1年生存率分别为900%和833%，差异无统计学意义（P＞0.05）。结论 CMNa联合CRT治疗局部中晚期食管癌具有增敏作用，且不增加近期毒副反应。

Clinical observation of sodium glycididazole combined with concurrent radiochemotherapy for locally ad-vanced esophageal cancer

Objective To evaluate the efficacy and side effects of sodium glycididazole（ CMNa） combined with concurrent ra-diochemotherapy（CRT） for locally advanced esophageal cancer. Methods From June 2012 to November 2013, 87 patients pathologically confirmed as esophageal cancer were randomized into CMNa＋CRT group（n=44） and CRT group（n=43）. Radiotherapy was given by 6 MV X-ray on conventional schedule（2. 0Gy/f, 5 fractions a week, DT 50Gy）. CMNa was given intravenously 800mg/m2, every Monday, Wednesday and Friday 0-3h before radiation. Chemotherapy regimen contained cisplatin 12. 5mg/m2 iv d1-d5 , and fluorouracil 450mg/m2 iv d1-d5 with 28 days of a cycle for 2 cycles. Results All patients were evaluable. Patients in CMNa＋CRT group achieved 31 CR, 8 PR, 4 SD, 1 PD, and responce rate（RR） was 90. 7%;While in CRT group,patients got 25 CR,7 PR, 9 SD, 2 PD, and RR was 74. 4%. There were significant differences between RR of the two groups（P=0. 043）. Main side effects were grade 1-2 bone marrow inhibition, hepatic dyfunction, radioactive esophagitis and radioactive pneumonia, with no differences（P〉0. 05）.The 1-year survival rates were 90. 0% and 83. 3% in CMNa＋CRT group and CRT group with no differences（ P〉0. 05） . Conclusion CMNa combined with CRT for lo-cally advanced esophageal cancer can improve healing efficacy obviously and do not cause severe side effects.