三維適形放療同步替吉奧治療老年術后復發食管癌的效果觀察

侯盤長+許妍+雒建超+等

侯盤長 許 妍 雒建超 王 偉 牛 坡

河南省人民醫院放療科，河南鄭州 450003

[摘要] 目的 觀察三維適形放療同步替吉奧化療治療老年術后復發食管癌的近期療效和毒副作用。 方法 37例老年食管癌術后復發患者，隨機分為單放組（19例）和同步組（18例）。放療應用三維適形放療（2.0 Gy/次，5次/周，總劑量60～66 Gy）；同步組：放療同步口服替吉奧膠囊化療（40 mg/m2，2次/d，口服，連服14 d，21 d為1個周期）。觀察兩組療效及不良反應。 結果 兩組患者均完成治療，依從性好。同步組有效率為83.0%，單放組有效率為68.4%，兩組比較，差異有統計學意義（P < 0.05）。主要毒副作用為放射性食管炎、消化道反應、血液學毒性、放射性皮膚反應，多為1、2級。 結論 三維適形放療同步替吉奧化療治療食管癌術后復發的療效確切，毒副作用可耐受，能明顯改善患者的生活質量。

[關鍵詞] 食管腫瘤；放射療法；三維適形；同期放化療法；替吉奧

[中圖分類號] R730.55 [文獻標識碼] A [文章編號] 1673-7210（2014）03（b）-0041-04

Efficacy observation of three-dimensional conformal radiation combined with S-1 treating for elderly postoperative esophageal

HOU Panzhang XU Yan LUO Jianchao WANG Wei NIU Po

Department of Oncology Radiotherapy， He'nan Provincial People's Hospital， He'nan Province， Zhengzhou 450003， China

[Abstract] Objective To observe the recent effect and side effect of three-dimensional conformal radiation combined with S-1 treating for elderly postoperative esophageal carcinoma. Methods 37 patients with elderly postoperative esophageal carcinoma were random divided into concurrent chemo-radiotherapy （CCRT） group （n = 18） and conventional radiotherapy alone group （CRT） （n = 19）. Both groups were treated with three-dimensional conformalradiation therapy （2.0 Gy/once， 5 times per week and the total dose was 60-66 Gy）. CCRT： the patients were given S-1 orally 40 mg/m2 twice/d for consecutive 14 days，and one cycle lasted for 21 days. The clinical effect and aduerse effect of the two groups were compared. Results All of the 37 patients' treatment were finished. The effective rate of CCRT and CRT were 83.0% and 68.4%， the difference was statistically significant （P < 0.05）. Major adverse effects were leukopenia， radiation esophagutis， anemia. Conclusion Three-dimensional conformal radiation combined with S-1 treating for elderly postoperative esophageal carcinoma has definite effect， high effective rate， patients show well tolerance， and without serious side effect. It can apparently improve the life quality of the patients.

[Key words] Esophageal carcinoma； Radiotherapy； 3-dimensionalconformal； Concurrent chemo-radiotherapy； S-1

我國是食管癌的高發國家，隨著我國人口老齡化趨勢，老年患者在食管癌的發病率構成比呈上升趨勢。隨著生活水平的提高，就診的老年食管癌患者一般體質尚可，故外科手術仍是治療食管癌的主要方法[1]，但患者仍常因術后復發和轉移而死亡[2]。放射治療是食管癌術后復發及局部轉移的主要治療手段，隨著放射治療設備、方法的更新，食管癌的放療療效有所提高，但預后仍不理想。因此，應用同步放化療方案治療復發性食管癌患者成為研究熱點。本研究……