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目的探讨三维适性放疗与区域性热疗及卡培他滨同步治疗食管癌及贲门癌腹膜后淋巴结转移的近期疗效及安全性。方法67例患者随机分为两组,治疗组采用三维适性放疗(3D-CRT)及服用卡培他滨配合区域性热疗治疗。3D-CRT分割剂量2～3Gy/次,5次/周,总剂量45～60Gy/15～30次,3～6周。卡培他滨2500mg/(m2·d),分两次口服,连用14d。区域性热疗每周2次,直至治疗结束。对照组放化疗方法同治疗组。同时检测两组治疗前后T细胞亚群变化。结果治疗组总有效率(CR+PR)为73.7%,症状缓解率为88.2%;对照组总有效率为51.7%,症状缓解率为64.0%,两组比较差异具有显著性。治疗后治疗组T细胞亚群中CD3+、CD4+、CD4+/CD8+均有一定程度升高,与对照组相比差异有显著性(P<0.05)。两组Ⅱ～Ⅲ级骨髓抑制比较差异无显著性。结论热放化疗同步治疗食管癌及贲门癌腹膜后淋巴结转移为一种安全有效的治疗手段。
Objective To investigate the short-term efficacy and safety of three-dimensional adaptive radiotherapy and regional hyperthermia combined with capecitabine in the treatment of retroperitoneal lymph node metastasis of esophageal and cardiac cancer. Methods 67 patients were randomly divided into two groups. The treatment group was treated with 3D-CRT and capecitabine combined with regional hyperthermia. 3D-CRT dose division 2 ~ 3Gy / time, 5 times / week, the total dose of 45 ~ 60Gy / 15 ~ 30 times, 3 ~ 6 weeks. Capecitabine 2500mg / (m2 · d), orally twice, once every 14d. Regional hyperthermia twice a week until treatment is over. The control group radiotherapy and chemotherapy with the treatment group. The changes of T cell subsets in both groups before and after treatment were also measured. Results The total effective rate (CR + PR) in the treatment group was 73.7%, the symptom relief rate was 88.2%. The total effective rate in the control group was 51.7% and the symptom relief rate was 64.0%. The differences between the two groups were significant. After treatment, the levels of CD3 +, CD4 +, CD4 + / CD8 + of T cell subsets in treatment group increased to a certain degree, which was significantly different from that in control group (P <0.05). There was no significant difference in bone marrow suppression between the two groups. Conclusions The simultaneous treatment of esophageal and cardia cancer with retroperitoneal lymph node metastasis by thermal radiotherapy is a safe and effective treatment.