论文部分内容阅读
目的探讨常规剂量紫杉醇联合铂类与放疗同步治疗食管癌的疗效,以及扩大照射野对同步放化疗疗效的影响。方法89例局部晚期食管癌初治患者,采用根治性同步放化疗,扩大野组51例,常规野组38例。放疗总剂量60 Gy(分两阶段进行),放疗的第1周和第4周给予常规剂量的紫杉醇和铂类化疗。结果87.6%的患者完成了治疗计划,扩大野组和常规野组的治疗有效率分别为75.5%和66.7%(P=0.37)。两组的Ⅲ级以上急性毒副反应主要为白细胞、血小板下降和放射性食管炎,主要远期放射损伤为肺纤维化,两组间各种毒副反应发生率差异均无统计学意义。患者总的3年生存率为32.8%,3年无复发转移生存率为34.5%,3年局部控制率为44.0%;扩大野组和常规野组的3年生存率、3年无复发转移生存率、3年局部控制率之间差异均无统计学意义。完成治疗计划的Ⅱ、Ⅲ期患者中,扩大野组3年生存率、3年无复发转移生存率及3年局部控制率较常规野组显著提高。结论常规剂量紫杉醇联合铂类化疗同步扩大野放疗对食管癌患者是安全的,可增加Ⅱ、Ⅲ期食管癌患者的局部控制率,提高3年生存率。
Objective To investigate the curative effect of conventional dose paclitaxel combined with platinum and radiotherapy on esophageal cancer and to explore the effect of radiotherapy on the curative effect of concurrent chemoradiotherapy. Methods 89 patients with locally advanced esophageal cancer were treated by radical concurrent chemoradiotherapy, expanding the wild group of 51 cases, routine group of 38 cases. A total dose of 60 Gy of radiotherapy (in two stages) was given at the first and fourth weeks of radiotherapy with conventional doses of paclitaxel and platinum. Results 87.6% of the patients completed the treatment plan. The effective rates of the extended group and the routine group were 75.5% and 66.7%, respectively (P = 0.37). The grade Ⅲ above acute toxicity was mainly leucocyte, thrombocytopenia and radiation esophagitis. The main long-term radiation injury was pulmonary fibrosis. There was no significant difference in the incidence of various toxic and side effects between the two groups. The overall 3-year survival rate was 32.8%. The 3-year recurrence-free survival rate was 34.5% and the 3-year local control rate was 44.0%. The 3-year survival rate of the extended group and the routine group was 3 years without recurrence and metastasis Rate, three-year local control rate differences were not statistically significant. Among the patients with stage Ⅱ and Ⅲ who completed the treatment plan, the 3-year survival rate, 3-year recurrence-free survival rate and 3-year local control rate in the extended field group were significantly higher than those in the routine field group. Conclusion Conventional extended-dose radiotherapy with paclitaxel combined with platinum-based chemotherapy is safe for patients with esophageal cancer and can increase the local control rate of patients with stage II and III esophageal cancer and improve the 3-year survival rate.