三维适形放疗联合同步化疗治疗食管癌31例疗效观察

    3-dimensional conformal radiotherapy combined with concurrent chemotherapy for esophageal cancer

    • 摘要: 目的: 评价三维适形放疗(3DCRT)联合同步化疗治疗食管癌的局部控制率、生存期和毒副作用。方法: 31例食管癌患者应用3DCRT 1.8~2 Gy/f,总放射剂量55~65 Gy;同步行化疗,放疗开始第1天应用顺铂30 mg/m2静脉滴注,每周1次至放疗结束。放疗结束后行2周期辅助化疗,顺铂20 mg静脉滴注5天,替加氟1.0 g静脉滴注5天,28天为1个周期。结果: 完全缓解22例,部分缓解7例,无变化2例,总有效率为93.55%;进食梗阻缓解率为96.77%。1、2、3年局部控制率分别为88%、51%、40%;1、2、3年生存率分别为93%、66%、58%;均发生急性放射性食管炎,≥ 3级占15%;白细胞下降发生率为56%,≥ 3级占34%。结论: 3DCRT联合同步顺铂方案治疗食管癌可提高局部控制率并延长生存期,毒副反应可耐受。

       

      Abstract: Objective: To evaluate the efficacy of 3-dimensional conformal radiotherapy (3DCRT) combined with concurrent chemotherapy in management of esophageal carcinoma. Methods: From Feb. 2006 to Aug. 2007,31 patients with esophageal carcinoma were treated by 3DCRT at a dose of 1.8-2 Gy/f (55-65 Gy in total); at the same time, cisplatin 30 mg/m2 was administered intravenously on the first day of each week until the end of the radiotherapy. After the therapy,chemotherapy regimen of cisplatin 20 mg plus tegafur 1.0 g were administered on day 1 to 5,every 28 days for two cycles. Results: Complete relief was observed in 22 cases, partial relief in 7 cases and no response in 2 cases,the overall response rate reached 93%; the food intake obstruction was relieved in 97% of the cases; the 1,2 and 3-year local control rates were 88%,51% and 40%,respectively; the 1,2 and 3-year survival rates were 93%,66% and 58%,respectively. Acute radiations esoph-agitis occurred in 100% of the cases,and 15% of them were at a grade of ≥ 3; leucopenia was observed in 56% of the cases,and 34% of them were at a grade of ≥ 3. Conclusions: 3DCRT combined with chemotherapy is an effective and well-tolerated regimen for treatment of patients with esophageal cancer.

       

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