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目的观察放化疗治疗中晚期食管癌患者的临床效果及不良反应。方法选择2013年12月-2014年9月中晚期非手术食管癌患者56例,随机分为观察组与对照组各28例。对照组予X线直线加速器照射放射治疗;治疗组在放射治疗基础上给予紫杉醇及奈达铂化疗。随访6~24个月,比较2组临床疗效、近期不良反应、1年生存率。结果观察组近期总有效率为78.6%明显高于对照组的57.1%(P<0.05)。观察组1年生存率为92.8%(26/28)明显高于对照组的64.3%(18/28)(P<0.05)。2组不良反应主要为放射性食管炎,骨髓抑制、胃肠道反应、血液毒性反应等,以1~2级不良反应为主。观察组1~2级不良反应发生率为高于对照组,而3~4级不良反应发生率低于对照组,差异均有统计学意义(P<0.01)。结论同步放化疗对中晚期食管癌患者的临床效果好,不良反应少,可提高短期生存率,值得临床推广应用。
Objective To observe the clinical effects and adverse reactions of radiotherapy and chemotherapy for patients with advanced esophageal cancer. Methods Fifty-six patients with advanced non-surgical esophageal cancer from December 2013 to September 2014 were randomly divided into observation group (28 cases) and control group (28 cases). The control group was treated with X-ray linear accelerator radiation therapy; the treatment group was given paclitaxel and nedaplatin on the basis of radiotherapy. The patients were followed up for 6-24 months. The clinical efficacy, recent adverse reactions and 1-year survival rate were compared between the two groups. Results The total effective rate in the observation group was 78.6%, significantly higher than that in the control group (57.1%, P <0.05). The 1-year survival rate was 92.8% (26/28) in observation group, which was significantly higher than 64.3% (18/28) in control group (P <0.05). Two groups of adverse reactions are mainly radio esophagitis, myelosuppression, gastrointestinal reactions, hematological toxicity, with 1 to 2 adverse reactions based. The incidence of grade 1 or 2 adverse reactions in the observation group was higher than that in the control group, while the incidence of grade 3 and 4 adverse reactions was lower than that in the control group (P <0.01). Conclusions Simultaneous chemoradiation has a good clinical effect on patients with advanced esophageal cancer, with fewer adverse reactions, which can improve the short-term survival rate and is worthy of clinical application.