發(fā)布時間：2019-01-12 20:35

【摘要】：目的:觀察不同放療劑量同期化療治療不能手術(shù)食管癌的臨床效果。方法:回顧性分析2005年5月1日至2007年6月31日,我科收治的可分析的初治食管癌患者的臨床結(jié)果,全組共78例,根據(jù)不同放療劑量分為高劑量組(DT50 Gy,平均64 Gy)和低劑量組(DT 50 Gy),其中低劑量組43例,高劑量組35例�；熤饕捎肞F方案,DDP 75 mg/m2 d1+5-FU 500~600 mg/m2 d2~5,于放療開始第1、28、49、70天應(yīng)用,共2~4周期。比較兩組患者的近期療效、毒副反應(yīng)以及生存率情況。結(jié)果 :高劑量組的完全緩解率和有效率與低劑量組相比無統(tǒng)計(jì)學(xué)差異(P=0.861)。高劑量組和低劑量組的1、3、5年生存率分別為71.4%、34.3%、25.7%和76.7%、41.9%、30.2%,中位生存期分別是19個月和22個月,兩者差異無統(tǒng)計(jì)學(xué)意義(P=0.661)。高劑量組3、4度骨髓抑制較低劑量組發(fā)生率高,但差異無統(tǒng)計(jì)學(xué)意義;3、4級放射性食管炎高劑量組較低劑量組明顯,差異有統(tǒng)計(jì)學(xué)意義(P=0.040)。結(jié)論:放療合并同期化療治療食管癌時,低劑量(50 Gy)放療可以達(dá)到與高劑量(50 Gy以上)放療近似的臨床效果,而低劑量組毒副反應(yīng)較輕。
[Abstract]:Objective: to observe the clinical effect of different doses of radiotherapy in the treatment of inoperable esophageal carcinoma. Methods: from May 1, 2005 to June 31, 2007, the clinical results of 78 patients with primary esophageal cancer treated in our department were retrospectively analyzed. According to different radiotherapy doses, 78 patients were divided into high dose group (DT50 Gy,). There were 43 cases in low dose group and 35 cases in high dose group (DT 50 Gy),). Chemotherapy was performed with PF regimen, DDP 75 mg/m2 d 1, 5-FU 500 5-FU 600 mg/m2 d 2, 5, at the beginning of radiotherapy on day 1, 28, 49 and 70, for 2 to 4 cycles. The short-term efficacy, toxicity and survival rate were compared between the two groups. Results: there was no significant difference in complete remission rate and effective rate between high dose group and low dose group (P < 0. 861). The survival rates of high dose group and low dose group were 71.4%, 34.3% and 41.9%, respectively. The median survival time was 19 months and 22 months, respectively. There was no significant difference between the two groups (P0. 661). The incidence of 3 ~ 4 degree bone marrow suppression in high dose group was higher than that in low dose group, but the difference was not statistically significant, and the difference was statistically significant (P0. 040) in the high dose group of 3 ~ 4 grade radiation esophagitis than in the low dose group (P < 0. 040). Conclusion: low dose (50 Gy) radiotherapy can achieve the same clinical effect as high dose (more than 50 Gy) radiotherapy in combination with concurrent chemotherapy for esophageal carcinoma, but the toxicity in low dose group is less than that in high dose (50 Gy) group.
【作者單位】： 汕頭大學(xué)醫(yī)學(xué)院附屬腫瘤醫(yī)院放療科;
【分類號】：R735.1;R730.55

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