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目的讨论老年食管癌单药奈达铂同步化疗的临床疗效和放射性肺炎的发生率,并初步讨论造成两者结果的不同影响因素。方法 80例老年食管癌患者随机分为两组,试验组(奈达铂+放疗)40例,单放组40例。两组放疗均采用6 MV或15 MV直线加速器治疗。两组均接受60～70Gy总剂量的常规疗程。试验组在放疗第一天开始,用奈达铂(奥先达)20 mg d1～7静脉滴注。三周为一疗程,共两疗程。结果 1,2,3年生存率试验组和单放组分别为84.8%、63.3%、25%和64.6%、46.6%、18.0%。两组相比较有统计学差异(P<0.01)。试验组放疗后发生放射性肺炎15例,占50.0%。单放组放疗后发生放射性肺炎13例,占46.0%。两组相比较无明显统计学差异。结论奈达铂+放疗治疗老年食管癌能在一定程度地提高患者的生存率,同时并不明显增加患者放射性肺炎的发生率。
Objective To discuss the clinical efficacy and incidence of radiation pneumonitis in esophageal cancer single-agent nedaplatin simultaneous chemotherapy and to discuss the different influencing factors of the results of the two. Methods Eighty elderly patients with esophageal cancer were randomly divided into two groups: 40 in experimental group (nedaplatin + radiotherapy) and 40 in radiotherapy alone group. Both groups were treated with 6 MV or 15 MV linear accelerator. Both groups received 60-70 Gy total dose of conventional treatment. The experimental group started on the first day of radiotherapy with nedaplatin (Aoxeda) 20 mg d1 ~ 7 intravenous infusion. Three weeks for a course of treatment, a total of two courses. Results The 1, 2, 3 year survival rates were 84.8%, 63.3%, 25% and 64.6%, 46.6% and 18.0% in the test group and the single operation group respectively. There was a significant difference between the two groups (P <0.01). Radiation pneumonitis occurred in 15 cases (50.0%) in the experimental group after radiotherapy. Radioactive pneumonitis occurred in 13 cases (46.0%) after radiotherapy alone. There was no significant difference between the two groups. Conclusion Nedaplatin + radiotherapy for esophageal cancer in elderly patients can improve the survival rate of patients to some extent, while not significantly increase the incidence of radiation pneumonitis in patients.