论文部分内容阅读
目的评价多西紫杉醇联合三维适形放疗(3DCRT)治疗中晚期食管癌的近期疗效、不良反应和长期生存率。方法90例食管癌患者根据入选标准随机分为两组。47例进入多西紫杉醇+3DCRT组(放化组),43例单纯3DCRT组(单放组)。治疗采用多西紫杉醇40mg,第1、8、15、22、29天,静脉滴注5周。放化组中3DCRT从应用多西紫杉醇第1天开始,DT60～64Gy,分30～32次进行,6.0～6.5周完成。结果放化组与单放组完全缓解率分别为66.0%和41.9%,有效率分别为93.6%和76.7%。1、2、3年局部控制率放化组分别为89.0%、78.9%、74.8%,单放组分别为79.0%、60.8%、50.0%。1、2、3年生存率放化组分别为79.9%、68.8%、50.2%,单放组分别为69.0%、50.3%、38.0%。放化组不良反应尤其是外周血白细胞减少和放射性食管炎的发生率均高于单放组(P<0.05),但在毒性Ⅲ、Ⅳ级反应方面两组差异无统计学意义(P>0.05),且患者均能耐受。结论采用多西紫杉醇联合三维适形放疗治疗中晚期食管癌的近期疗效和局部控制率较高,且可以提高远期生存率,虽不良反应增加但可以耐受。
Objective To evaluate the short-term effect, side effects and long-term survival of docetaxel combined with three-dimensional conformal radiotherapy (3DCRT) in the treatment of advanced esophageal cancer. Methods 90 patients with esophageal cancer were randomly divided into two groups according to the inclusion criteria. 47 cases entered docetaxel + 3DCRT group (radiotherapy group), 43 cases of simple 3DCRT group (radiotherapy group). Treatment with docetaxel 40mg, the first 1,8,15,22,29 days, intravenous infusion for 5 weeks. In the radiotherapy group, 3DCRT started from Day 1 after application of docetaxel and DT60 ~ 64Gy at 30 ~ 32 times, completing 6.0 ~ 6.5 weeks. Results The complete remission rate of radiotherapy group and single radiotherapy group were 66.0% and 41.9%, respectively, and the effective rates were 93.6% and 76.7% respectively. The local control rates of 1, 2 and 3 years were 89.0%, 78.9% and 74.8% respectively, and 79.0%, 60.8% and 50.0% respectively in the single operation group. The 1-, 2- and 3-year survival rates were 79.9%, 68.8% and 50.2% respectively in the radiotherapy group and 69.0%, 50.3% and 38.0% in the radiotherapy alone group, respectively. The incidence of adverse reactions, especially peripheral leucocytopenia and radiation esophagitis in radiotherapy group were significantly higher than those in radiotherapy alone group (P <0.05), but there was no significant difference between the two groups in toxicity grade Ⅲ and Ⅳ (P> 0.05 ), And patients can tolerate. Conclusion The combination of docetaxel and three-dimensional conformal radiotherapy for the treatment of advanced esophageal cancer, the short-term efficacy and local control rate is high, and can improve the long-term survival rate, although the adverse reactions increased but can be tolerated.