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目的探讨奈达铂联合紫杉醇同步三维适形放疗治疗进展期食管癌的疗效及毒性。方法 36例进展期食管癌患者,随机分为奈达铂联合紫杉醇同步放化疗组(TP组)18例和顺铂联合氟尿嘧啶同步放化疗组(DF组)18例,两组放疗均采用三维适形放疗,常规分割,照射剂量60~66 Gy。对比两组临床疗效,1年生存率及不良反应。结果 TP组完全缓解8例,部分缓解8例,有效率88.9%;DF组完全缓解4例,部分缓解6例,有效率55.6%,两组比较差异有统计学意义(P<0.05)。TP组Ⅱ度以上白细胞下降占55.6%,明显高于DF组的16.7%(P<0.05),TP组Ⅲ度血小板下降2例,DF组无Ⅲ度血小板下降病例。两组Ⅱ~Ⅲ度放射性食管炎发生率比较差异无统计学意义(37.5%VS 32.0%,P>0.05)。结论奈达铂联合紫杉醇同步三维适形放疗治疗进展期食管癌近期疗效较好,骨髓抑制加重但可耐受。
Objective To investigate the efficacy and toxicity of nedaplatin plus paclitaxel in simultaneous three-dimensional conformal radiotherapy for advanced esophageal cancer. Methods Thirty-six patients with advanced esophageal cancer were randomly divided into nidogen combined with paclitaxel and chemotherapeutic group (TP group), 18 cases and cisplatin plus fluorouracil concurrent chemoradiotherapy group (DF group), 18 cases were treated with three-dimensional Radiotherapy, conventional segmentation, irradiation dose of 60 ~ 66 Gy. The clinical efficacy, 1-year survival rate and adverse reactions of the two groups were compared. Results In the TP group, 8 cases were completely relieved, 8 cases partially relieved, and the effective rate was 88.9%. In the DF group, 4 cases were completely relieved and 6 cases partially relieved. The effective rate was 55.6%. There was significant difference between the two groups (P <0.05). In group TP, the leukopenia of grade Ⅱ and above was 55.6%, which was significantly higher than that of DF group (16.7%, P <0.05). The grade Ⅲ thrombocytopenia in TP group was decreased in 2 cases and in DF group there was no case of grade Ⅲ thrombocytopenia. There was no significant difference in the incidence of Ⅱ ~ Ⅲ degree esophagitis between the two groups (37.5% VS 32.0%, P> 0.05). Conclusion Nedaplatin combined with paclitaxel three-dimensional conformal radiotherapy for the treatment of advanced esophageal cancer better curative effect, bone marrow suppression increased but can be tolerated.