不同放疗剂量同期化疗治疗不能手术食管癌的临床分析

发布时间：2019-01-12 20:35

【摘要】：目的:观察不同放疗剂量同期化疗治疗不能手术食管癌的临床效果。方法:回顾性分析2005年5月1日至2007年6月31日,我科收治的可分析的初治食管癌患者的临床结果,全组共78例,根据不同放疗剂量分为高剂量组(DT50 Gy,平均64 Gy)和低剂量组(DT 50 Gy),其中低剂量组43例,高剂量组35例。化疗主要采用PF方案,DDP 75 mg/m2 d1+5-FU 500~600 mg/m2 d2~5,于放疗开始第1、28、49、70天应用,共2~4周期。比较两组患者的近期疗效、毒副反应以及生存率情况。结果 :高剂量组的完全缓解率和有效率与低剂量组相比无统计学差异(P=0.861)。高剂量组和低剂量组的1、3、5年生存率分别为71.4%、34.3%、25.7%和76.7%、41.9%、30.2%,中位生存期分别是19个月和22个月,两者差异无统计学意义(P=0.661)。高剂量组3、4度骨髓抑制较低剂量组发生率高,但差异无统计学意义;3、4级放射性食管炎高剂量组较低剂量组明显,差异有统计学意义(P=0.040)。结论:放疗合并同期化疗治疗食管癌时,低剂量(50 Gy)放疗可以达到与高剂量(50 Gy以上)放疗近似的临床效果,而低剂量组毒副反应较轻。
[Abstract]:Objective: to observe the clinical effect of different doses of radiotherapy in the treatment of inoperable esophageal carcinoma. Methods: from May 1, 2005 to June 31, 2007, the clinical results of 78 patients with primary esophageal cancer treated in our department were retrospectively analyzed. According to different radiotherapy doses, 78 patients were divided into high dose group (DT50 Gy,). There were 43 cases in low dose group and 35 cases in high dose group (DT 50 Gy),). Chemotherapy was performed with PF regimen, DDP 75 mg/m2 d 1, 5-FU 500 5-FU 600 mg/m2 d 2, 5, at the beginning of radiotherapy on day 1, 28, 49 and 70, for 2 to 4 cycles. The short-term efficacy, toxicity and survival rate were compared between the two groups. Results: there was no significant difference in complete remission rate and effective rate between high dose group and low dose group (P < 0. 861). The survival rates of high dose group and low dose group were 71.4%, 34.3% and 41.9%, respectively. The median survival time was 19 months and 22 months, respectively. There was no significant difference between the two groups (P0. 661). The incidence of 3 ~ 4 degree bone marrow suppression in high dose group was higher than that in low dose group, but the difference was not statistically significant, and the difference was statistically significant (P0. 040) in the high dose group of 3 ~ 4 grade radiation esophagitis than in the low dose group (P < 0. 040). Conclusion: low dose (50 Gy) radiotherapy can achieve the same clinical effect as high dose (more than 50 Gy) radiotherapy in combination with concurrent chemotherapy for esophageal carcinoma, but the toxicity in low dose group is less than that in high dose (50 Gy) group.
【作者单位】：汕头大学医学院附属肿瘤医院放疗科;
【分类号】：R735.1;R730.55

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