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目的对比非手术食管癌患者采取mFOLFOX6方案同步放化疗与传统PF方案同步放化疗的疗效差异。方法 60例Ⅱ/Ⅲ期非手术食管鳞癌患者,随机分为试验组(27例)和对照组(33例)。两组均采用三维适形放疗(3D-CRT)。试验组放疗期间予以mFOLFOX6方案同步化疗,对照组放疗期间予以PF方案同步化疗。分析两组近期疗效、治疗毒性反应。结果试验组近期总有效率为92.59%,高于对照组的75.76%,但差异无统计学意义(P>0.05)。两组主要毒性为骨髓抑制、消化道反应及神经毒性反应。骨髓抑制主要表现为白细胞减少,其中试验组Ⅲ~Ⅳ度骨髓抑制发生率为22.2%(6/27),对照组为27.3%(9/33),比较差异无统计学意义(P>0.05)。消化道反应主要表现为放射性食管炎、恶心、呕吐。两组均未发生Ⅲ度以上食管炎;试验组恶心、呕吐发生率29.6%(8/27)对照组为60.6%(20/33),比较差异有统计学意义(P=0.017<0.05)。两组外周神经毒性均为轻度,试验组发生率为66.7%(18/27),对照组为57.6%(19/33),比较差异无统计学意义(P>0.05)。所有不良反应经对症治疗后均可缓解,患者能良好耐受。结论与传统PF方案同步放化疗比较,mFOLFOX6方案同步放化疗治疗非手术食管鳞癌患者近期总有效率较高,近期疗效好,不良反应可耐受,值得进一步研究。
Objective To compare the curative effects of concurrent chemoradiation with mFOLFOX6 regimen and traditional PF regimen in patients with non-surgical esophageal cancer. Methods Sixty patients with stage Ⅱ / Ⅲ nonsurgical esophageal squamous cell carcinoma were randomly divided into experimental group (n = 27) and control group (n = 33). Three-dimensional conformal radiotherapy (3D-CRT) was used in both groups. The experimental group was treated with mFOLFOX6 regimen during radiotherapy and the control group received concurrent PF regimen during radiotherapy. Analysis of two groups of recent curative effect, the treatment of toxic reactions. Results The total effective rate of the experimental group was 92.59%, which was higher than that of the control group (75.76%), but the difference was not statistically significant (P> 0.05). The main toxicity of two groups of bone marrow suppression, gastrointestinal reactions and neurotoxic reactions. Myelosuppression mainly showed leukopenia. The incidence of grade Ⅲ ~ Ⅳ myelosuppression in trial group was 22.2% (6/27) and that in control group was 27.3% (9/33), with no significant difference (P> 0.05) . Gastrointestinal reactions mainly for radiation esophagitis, nausea, vomiting. The incidence of nausea and vomiting was 29.6% (8/27) in the control group and 60.6% (20/33) in the control group. The difference was statistically significant (P = 0.017 <0.05). The peripheral neurotoxicity was mild in both groups, with the incidence of 66.7% (18/27) in the experimental group and 57.6% (19/33) in the control group, with no significant difference (P> 0.05). All adverse reactions can be alleviated after symptomatic treatment, patients with good tolerance. Conclusion Compared with the traditional PF regimen concurrent chemoradiotherapy, mFOLFOX6 regimen concurrent chemoradiotherapy in patients with non-surgical esophageal squamous cell carcinoma of the recent total effective, the recent good effect, adverse reactions can tolerate, worthy of further study.