本文選題：食管癌　切入點(diǎn)：雷替曲塞　出處：《南京醫(yī)科大學(xué)》2017年博士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:觀察雷替曲塞聯(lián)合順鉑對(duì)比多西他賽聯(lián)合順鉑同步放化療治療中晚期食管癌的療效及不良反應(yīng)。方法:104例初治的局部晚期食管鱗癌患者,利用隨機(jī)數(shù)字表法隨機(jī)分成雷替曲塞組(54例)及多西他賽組(50例),采用調(diào)強(qiáng)放療(IMRT)或三維適形放療(3D-CRT);雷替曲塞組在放療時(shí)同步應(yīng)用雷替曲塞聯(lián)合順鉑化療2個(gè)周期,多西他賽組則同步應(yīng)用多西他賽聯(lián)合順鉑化療2個(gè)周期;按照實(shí)體瘤治療療效評(píng)價(jià)標(biāo)準(zhǔn)(RECIST 1.1版)和美國(guó)國(guó)立癌癥研究所不良反應(yīng)常用術(shù)語(yǔ)評(píng)定標(biāo)準(zhǔn)(NCI-CTCAE)4.0版,比較兩組的近期療效及不良反應(yīng),同時(shí)初步觀察兩組患者的1年生存率和無(wú)進(jìn)展生存率。結(jié)果:雷替曲塞組的客觀有效率(RR)是85.2%,疾病控制率(DCR)是94.4%,而多西他賽組分別是80.0%和92.0%,兩個(gè)組的RR(P=0.485)和DCR(P=0.708)比較均沒(méi)有統(tǒng)計(jì)學(xué)差異;雷替曲塞組1年生存率預(yù)計(jì)值為85.1%;多西他賽組的1年生存率預(yù)計(jì)值為71.0%,兩組有統(tǒng)計(jì)學(xué)意義(χ2=4.181,P=0.041);中位無(wú)進(jìn)展生存時(shí)間、1年無(wú)進(jìn)展生存率兩組無(wú)明顯差異(χ2=2.931,P=0.087);雷替曲塞組的1年局部無(wú)進(jìn)展生存率要優(yōu)于多西他賽組(χ2=4.063,P=0.044)。主要的不良反應(yīng)是骨髓抑制、胃腸道反應(yīng)和谷丙轉(zhuǎn)氨酶、谷草轉(zhuǎn)氨酶的升高,兩組不良反應(yīng)之間的差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:雷替曲塞聯(lián)合順鉑同步放化療可提高局部晚期食管癌的1年生存率和局部無(wú)進(jìn)展生存率,不良反應(yīng)可以耐受,值得進(jìn)一步開(kāi)展大規(guī)模的隨機(jī)對(duì)照研究來(lái)確認(rèn)。
[Abstract]:Objective: to observe the efficacy and side effects of retitrexide combined with docetaxel combined with cisplatin in the treatment of advanced esophageal carcinoma. The method of random digital table was used to divide randomly into two groups: retitrexed group (n = 54), doxetaxel group (n = 50), intensity modulated radiotherapy (IMRT) or 3D conformal radiotherapy (n = 3D-CRTX), retitrexed group (n = 54) and combined chemotherapy with cisplatin (n = 2). The docetaxel group was treated simultaneously with docetaxel combined with cisplatin chemotherapy for 2 cycles; according to the criteria for evaluating the efficacy of solid tumor therapy, RECIST 1.1) and the NCI-CTCAE 4.0 standard for the evaluation of adverse reactions commonly used by the National Cancer Institute. To compare the short-term curative effect and adverse reaction between the two groups, Results: the objective effective rate was 85.2, the disease control rate was 94.4 and the docetaxel group was 80.0% and 92.0, respectively. There was no statistical difference. The 1-year survival rate of the retetroce group was 85.1 and that of the docetaxel group was 71.0, with statistical significance between the two groups (蠂 ~ (2 / 2) 4.181). The median progression-free survival time was not significantly different between the two groups (蠂 ~ (2) 2.931P 0.087) (蠂 ~ 2 / 931P 0.087). The 1-year local progression-free survival rate in the docetaxel group was better than that in the docetaxel group (蠂 2, 4.063, P < 0.044). The main adverse effect was bone marrow suppression. Gastrointestinal reactions and elevated levels of alanine aminotransferase, alanine aminotransferase, and alanine aminotransferase, There was no significant difference in adverse reactions between the two groups (P 0.05). Conclusion: the 1-year survival rate and local progression-free survival rate of local advanced esophageal carcinoma can be improved by Reititrexide combined with cisplatin radiotherapy and chemotherapy, and the adverse reactions can be tolerated. Further large-scale randomized controlled studies are worthy of confirmation.
【學(xué)位授予單位】：南京醫(yī)科大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R735.1

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