国际肿瘤学杂志 ›› 2015, Vol. 42 ›› Issue (4): 252-254.doi: 10.3760/cma.j.issn.1673-422X.2015.04.004

• 论著 • 上一篇    下一篇

卡培他滨联合调强放疗治疗食管癌术后纵隔淋巴结转移的近期疗效观察

  

  1. 252000 山东省聊城市人民医院放疗科
  • 出版日期:2015-04-08 发布日期:2015-04-22
  • 通讯作者: 李学章,Email:1290958739@qq.com

Curative effect observation of capecitabine combined with intensity modulated radiotherapy for posto-perative mediastinum lymphonode metastasis in esophageal carcinoma

  1. Department of Oncology, Liaocheng People′s Hospital, Liaocheng 25200, China
  • Online:2015-04-08 Published:2015-04-22
  • Contact: Li Xuezhang, Email:1290958739@qq.com

摘要: 目的观察卡培他滨联合调强放疗治疗食管癌术后纵隔淋巴结转移的近期疗效及不良反应。方法62例食管癌术后纵隔淋巴结转移的患者按随机数字表法随机分为2组,单纯调强放疗组(A组)31例,卡培他滨联合调强放疗组(B组)31例。A组仅采用调强放疗,B组采用调强放疗联合口服卡培他滨化疗。两组放疗方案、计划相同:总剂量60~66 Gy,(30~33)次/(6~6.5)周,卡培他滨1 250 mg/m2,每日2次,连续14 d,21 d为1周期,共应用2疗程。治疗期间观察放化疗相关不良反应,放疗结束后1个月复查胸部CT评价疗效。结果A组: 完全缓解(CR)7 例,部分缓解(PR) 12例,无效(SD)10 例,进展(PD)2例,有效率为61.3% (19/31);B 组: CR 10 例, PR 16 例, SD 4 例, PD 1 例,有效率为83.9% (26/31),两组有效率差异有统计学意义(χ2=3.971, P<0.05)。A、B组的骨髓抑制发生率分别为29.0%、38.7%(χ2=0.648, P=0.421),放射性肺炎发生率分别为19.4%、25.8%(χ2=0.369,P=0.544),差异无统计学意义。结论卡培他滨联合调强放疗治疗食管癌术后纵隔淋巴结转移近期疗效满意,未增加放化疗相关不良反应。

关键词: 放射疗法, 调强适形, 食管肿瘤, 淋巴转移, 卡培他滨

Abstract: ObjectiveTo evaluate the efficacy and toxicity of capecitabine combined with intensity modulated radiotherapy (IMRT) for postoperative mediastinal lymph node metastasis in esophageal cancer. MethodsA total of 62 esophageal cancer patients with postoperative mediastinal lymph node metastases were randomly divided into the irradiation group (A group, 31 cases) and the capecitabine combined with IMRT group ( B group, 31 cases). Both of two groups received IMRT radiotherapy with a total dose of 6066 Gy, 3033 times in 66.5 weeks. The patients in B group were treated with capecitabine (1 250mg/m2, 2 f/d, d1d14, 21 d×2 cycle). ResultsGroup A: there were 7 cases of complete response (CR), 12 of  partial response (PR), 10 of stable disease (SD), and 2 of progressive disease(PD); the effective rate was 61.3%(19/31). Group B: there were 10 cases of CR, 16 of PR, 4 of SD, and 1of PD; the effective rate was 83.9%(26/31). There was a statistical significance between the effective rates of A group and B group(χ2=3.971, P<0.05). Our experiment showed that the rates of grade Ⅱand Ⅲ myelosuppression in group A and group B were 29.0% and 38.7%(χ2=0.648, P=0.421). The rates of Ⅰ and Ⅱ level radioactive pneumonia in group A and were 19.4% and 25.8%(χ2=0.369, P=0.544). The different incidence of the two adverse reactions between group A and B had no statistical significance. ConclusionCompared with IMRT alone, IMRT combined with capecitabine may have better curative efficacy without increasing toxicity to esophageal cancer patients with postoperative mediastinum lymphonode metastasis

Key words: Radiotherapy, intensitymodulated, Esophageal neoplasms, Lymphonode metastasis, Capecitabine