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目的探讨中晚期食管癌应用奈达铂联合适形放疗的临床疗效。方法选取2002年1月至2008年1月收治的74例中晚期食管癌患者(均经病理证实),随机分为观察组和对照组,每组各37例。对照组采用单纯的三维适形放疗(6MV-X射线或15MV-X射线行常规放疗,2.0Gy/次,每周5次),观察组先进行奈达铂化疗(奈达铂静脉滴注给药30～40mg/次,每周1次),之后再采用与对照组相同的放射治疗,在治疗结束后统计并对比两组患者的近期疗效、不良反应发生率以及随访评估远期的疗效。结果观察组总疗效(78.4%)明显高于对照组(51.5%),差异有统计学意义(P<0.05)。观察组患者的1～3年局部控制率(78.4%)明显高于对照组(51.5%),两组差异具有统计学意义(P<0.05)。观察组患者的存活率(51.5%)明显高于对照组(27.0%),两组差异具有统计学意义(P<0.05)。近期不良反应发生率两组患者无明显差异,不具有统计学意义(P>0.05)。结论中晚期食管癌患者采用奈达铂化疗联合三维适形放疗的治疗方法明显优于单纯放疗治疗,值得在临床上加以推广和应用。
Objective To investigate the clinical efficacy of nedaplatin combined with conformal radiotherapy for advanced esophageal cancer. Methods From January 2002 to January 2008, 74 patients with advanced esophageal cancer who were confirmed by pathology were randomly divided into observation group and control group, with 37 cases in each group. The control group received simple three-dimensional conformal radiotherapy (6MV-X-ray or 15MV-X-ray conventional radiotherapy, 2.0Gy / time, 5 times a week). The observation group received nedaplatin chemotherapy Drug 30 ~ 40mg / time, once a week), and then use the same radiotherapy as the control group after the end of treatment statistics and comparison of two groups of patients with short-term efficacy, the incidence of adverse reactions and follow-up assessment of long-term efficacy. Results The total efficacy (78.4%) in observation group was significantly higher than that in control group (51.5%), the difference was statistically significant (P <0.05). In the observation group, the local control rate (78.4%) in 1-3 years was significantly higher than that in control group (51.5%), with significant difference between the two groups (P <0.05). Survival rate in observation group (51.5%) was significantly higher than that in control group (27.0%), the difference was statistically significant (P <0.05). The incidence of adverse reactions in the recent two groups no significant difference, not statistically significant (P> 0.05). Conclusion The treatment of advanced esophageal cancer patients treated with nedaplatin chemotherapy combined with three-dimensional conformal radiotherapy is superior to radiotherapy alone, which is worth to be popularized and applied clinically.