The clinical observation of the tegafur combined with body gamma knife in the treatment of esophageal neoplasm complicated with retroperitoneal lymph node metastasis
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摘要: 目的: 探讨替吉奥(S1)联合体部伽马刀治疗食管癌腹膜后淋巴结转移的疗效及不良反应。方法: 回顾性分析69例食管癌腹膜后淋巴结转移患者临床资料, 体部伽马刀治疗时用真空垫和三维立体定向体架固定, 增强CT扫描, 肿瘤靶区外扩10 mm为计划靶区, 50%等剂量线包绕95%计划靶区为处方剂量线, 每次350～450 cGy, 5次/周。10～12次完成。肿瘤边缘总剂量:4 200～4 950 cGy。69例中联合组36例, 行体部伽马刀治疗联合口服S1 40 mg/m2,2次/天, 口服21 d, 28 d为1个周期, 口服4个周期;对照组33例, 单纯行体部伽马刀治疗。结果: 联合组近期总有效率和1年生存率分别为86.11%、77.78%, 对照组分别为63.63%、54.54%, 联合组1年生存率高于对照组(P<0.05)。联合组疼痛缓解总有效率为91.18%, 对照组77.42%, 差异无统计学意义(P>0.05)。2组患者治疗过程中的急性不良反应差异均无统计学意义(P>0.05), 患者均可耐受, 经积极治疗可好转, 未发生治疗相关性病死亡。结论: S1联合体部伽马刀治疗食管癌腹膜后淋巴结转移可提高1年生存率, 不良反应无明显增加。Abstract: Objective: To evaluate the effects and adverse reactions of the tegafur combined with body gamma knife in the treatment of patients with esophageal neoplasm complicated with retroperitoneal lymph node metastasis.Methods: The clinical data of 69 esophageal neoplasm patients with retroperitoneal lymph node metastases were retrospectively analyzed.Fixing vacuum pad and three-dimensional stereotactic body,enhancing CT scan,enlarging the tumor target area for 10 mm as planning target area,50% dose line embracing 95% planning target area as prescription dose curve and 350 to 450 cGy one time(5 times a week) were implemented at the time of body gamma knife therapy.The treatment was consist of 10 to 12 times,and the total dose of the tumor margin was 4 200-4 950 cGy.Among 69 cases,36 patients(combination group) were treated with the body gamma knife combined with tegafur(40 mg/m2,2 times 1 d,28 days 1 cycle for 4 cycles),33 patients(control group) were only treated with the body gamma knife therapy.Results: The short-term effective rate and 1-year survival rate in the combination group and control group were 86.11% & 77.78% and 63.63% & 54.54%,respectively.The 1-year survival rate in the combination group was higher than that in the control group(P<0.05).The total effective rate of pain relief in the combination group and control group were 91.18% and 77.42%,respectively,the difference of which was not statistically significant(P>0.05).The difference of the acute adverse reaction between two groups was not statistically significant(P>0.05).The patients could tolerate,and were improved after positive treatment.No case died.Conclusions: The treatment of patients with esophageal neoplasm complicated with retroperitoneal lymph node metastasis with tegafur combined with body gamma knife treatment can improve 1-year survival rate,and does not increase the adverse reaction of patients.
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