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目的探讨局部中晚期食管癌患者应用多烯紫杉醇联合奈达铂同步放化疗的治疗效果和安全性。方法 42例局部中晚期食管癌患者随机分为观察组和对照组各21例,2组均采用三维适形放疗,并于放疗第1天同步进行化疗,对照组化疗应用顺铂+多烯紫杉醇方案,观察组应用奈达铂+多烯紫杉醇方案。2组化疗均每21d为1个周期,出现Ⅱ度及以上血小板减少症、Ⅱ度以上粒细胞减少症患者停止化疗。比较2组同步放化疗结束时及治疗3个月后疗效及不良反应发生情况,随访观察1a生存率。结果对照组完成化疗周期55个,观察组完成60个;观察组同步放化疗结束、治疗3个月后有效率(85.71%、90.48%)和疾病控制率(100.00%、100.00%)与对照组(76.19%、80.95%和90.48%、95.24%)比较差异均无统计学意义(P>0.05);观察组1a生存率(80.95%)高于对照组(61.90%)(P<0.05);放化疗期间,观察组Ⅰ~Ⅱ、Ⅲ~Ⅳ级食欲下降(28.57%、23.81%)、恶心(38.10%、9.52%)、呕吐(14.29%、9.52%)、肾功能损害(23.81%、14.29%)发生率均低于对照组[食欲下降(61.90%、38.10%)、恶心(71.43%、28.57%)、呕吐(57.14%、33.33%)、肾功能损害(47.62%、38.10%)],差异均有统计学意义(P<0.05)。结论与多烯紫杉醇联合顺铂同步放化疗比较,局部中晚期食管癌患者应用多烯紫杉醇联合奈达铂同步放化疗治疗胃肠道不良反应较轻,1a生存率较高。
Objective To investigate the efficacy and safety of concurrent docetaxel combined with nedaplatin in the treatment of advanced esophageal cancer. Methods Forty-two patients with locally advanced esophageal cancer were randomly divided into observation group (21 cases) and control group (21 cases). Both groups were treated with three-dimensional conformal radiotherapy and chemotherapy was performed on the first day of radiotherapy. In the control group, cisplatin plus docetaxel Program, the observation group application of nedaplatin + docetaxel program. Two groups of chemotherapy every 21d for a cycle, there Ⅱ degree and above thrombocytopenia, grade Ⅱ or more patients with neutropenia chemotherapy. The curative effect and adverse reactions of the two groups were compared at the end of concurrent chemoradiotherapy and 3 months after treatment. The survival rate of 1a was observed. Results The control group completed 55 cycles of chemotherapy and the observation group completed 60 cycles. Concurrently with concurrent chemotherapy and radiotherapy in the observation group, the effective rates (85.71%, 90.48%) and disease control rates (100.00%, 100.00% (76.19%, 80.95% and 90.48%, 95.24% respectively). There was no significant difference in the survival rate of observation group 1a (80.95% vs 61.90%, P <0.05) During the chemotherapy, appetite decreased (28.57%, 23.81%), nausea (38.10%, 9.52%), vomiting (14.29%, 9.52%), renal dysfunction (23.81%, 14.29% ) Were lower than those in the control group [decreased appetite (61.90%, 38.10%), nausea (71.43%, 28.57%), vomiting (57.14%, 33.33%) and renal dysfunction (47.62%, 38.10% All were statistically significant (P <0.05). Conclusions Compared with docetaxel plus cisplatin in concurrent chemoradiotherapy, patients with locally advanced esophageal cancer treated with docetaxel combined with nedaplatin concurrent chemoradiotherapy are less likely to have gastrointestinal adverse reactions and have a higher survival rate.