雷替曲塞联合顺铂对比多西赛联合顺铂同步放疗治疗食管癌临床研究

发布时间：2018-03-13 19:06

本文选题：食管癌　切入点：雷替曲塞　出处：《南京医科大学》2017年博士论文　论文类型：学位论文

【摘要】：目的:观察雷替曲塞联合顺铂对比多西他赛联合顺铂同步放化疗治疗中晚期食管癌的疗效及不良反应。方法:104例初治的局部晚期食管鳞癌患者,利用随机数字表法随机分成雷替曲塞组(54例)及多西他赛组(50例),采用调强放疗(IMRT)或三维适形放疗(3D-CRT);雷替曲塞组在放疗时同步应用雷替曲塞联合顺铂化疗2个周期,多西他赛组则同步应用多西他赛联合顺铂化疗2个周期;按照实体瘤治疗疗效评价标准(RECIST 1.1版)和美国国立癌症研究所不良反应常用术语评定标准(NCI-CTCAE)4.0版,比较两组的近期疗效及不良反应,同时初步观察两组患者的1年生存率和无进展生存率。结果:雷替曲塞组的客观有效率(RR)是85.2%,疾病控制率(DCR)是94.4%,而多西他赛组分别是80.0%和92.0%,两个组的RR(P=0.485)和DCR(P=0.708)比较均没有统计学差异;雷替曲塞组1年生存率预计值为85.1%;多西他赛组的1年生存率预计值为71.0%,两组有统计学意义(χ2=4.181,P=0.041);中位无进展生存时间、1年无进展生存率两组无明显差异(χ2=2.931,P=0.087);雷替曲塞组的1年局部无进展生存率要优于多西他赛组(χ2=4.063,P=0.044)。主要的不良反应是骨髓抑制、胃肠道反应和谷丙转氨酶、谷草转氨酶的升高,两组不良反应之间的差异无统计学意义(P0.05)。结论:雷替曲塞联合顺铂同步放化疗可提高局部晚期食管癌的1年生存率和局部无进展生存率,不良反应可以耐受,值得进一步开展大规模的随机对照研究来确认。
[Abstract]:Objective: to observe the efficacy and side effects of retitrexide combined with docetaxel combined with cisplatin in the treatment of advanced esophageal carcinoma. The method of random digital table was used to divide randomly into two groups: retitrexed group (n = 54), doxetaxel group (n = 50), intensity modulated radiotherapy (IMRT) or 3D conformal radiotherapy (n = 3D-CRTX), retitrexed group (n = 54) and combined chemotherapy with cisplatin (n = 2). The docetaxel group was treated simultaneously with docetaxel combined with cisplatin chemotherapy for 2 cycles; according to the criteria for evaluating the efficacy of solid tumor therapy, RECIST 1.1) and the NCI-CTCAE 4.0 standard for the evaluation of adverse reactions commonly used by the National Cancer Institute. To compare the short-term curative effect and adverse reaction between the two groups, Results: the objective effective rate was 85.2, the disease control rate was 94.4 and the docetaxel group was 80.0% and 92.0, respectively. There was no statistical difference. The 1-year survival rate of the retetroce group was 85.1 and that of the docetaxel group was 71.0, with statistical significance between the two groups (蠂 ~ (2 / 2) 4.181). The median progression-free survival time was not significantly different between the two groups (蠂 ~ (2) 2.931P 0.087) (蠂 ~ 2 / 931P 0.087). The 1-year local progression-free survival rate in the docetaxel group was better than that in the docetaxel group (蠂 2, 4.063, P < 0.044). The main adverse effect was bone marrow suppression. Gastrointestinal reactions and elevated levels of alanine aminotransferase, alanine aminotransferase, and alanine aminotransferase, There was no significant difference in adverse reactions between the two groups (P 0.05). Conclusion: the 1-year survival rate and local progression-free survival rate of local advanced esophageal carcinoma can be improved by Reititrexide combined with cisplatin radiotherapy and chemotherapy, and the adverse reactions can be tolerated. Further large-scale randomized controlled studies are worthy of confirmation.
【学位授予单位】：南京医科大学
【学位级别】：博士
【学位授予年份】：2017
【分类号】：R735.1

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