卡培他滨增敏联合后程加速超分割放射治疗食管癌的疗效观察

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1、卡培他滨增敏联合后程加速超分割放射治疗食管癌的疗效观察【摘要】目的探讨口服卡培他滨增敏联合后程加速超分割(简称后超)放射治疗食管癌的近期疗效、生存期及毒副反应。方法将82例食管癌患者随机分为后超+卡培他滨组（治疗组）和单纯后超组（对照组）。放疗前2/3疗程常规分割，即2?Gy/次，5次/周，共40?Gy，后1/3疗程1.5?Gy/次，2次/d，间隔6?h或以上，5?d/周，总剂量65～70?Gy。治疗组自放疗第1?d开始口服卡培他滨1?000?mg/m2，2次/d，连续服用14?d，休息7?d，治疗周期为21?d,共治疗2个周期。结果82

2、例患者全部完成治疗计划，治疗组和对照组近期疗效分别为89.7%和76.9%，差异有统计学意义（P＜0.05）,1年生存率分别为80.5%和73.2%(P＞0.05)，放射性食管炎和骨髓抑制的发生率，两组差异无统计学意义。结论口服卡培他滨增敏联合后程加速超分割放疗可提高食管癌的近期疗效，未增加毒副反应，耐受性良好，远期疗效仍需进一步观察。【关键词】食管肿瘤；放射疗法；药物疗法；放射剂量分次　　　Toevaluatetheresponse,survivalandtoxicityofcapecitabinecombinedwithlatecou

3、rseaccelerated10hyperfractionatedradiotherapy(LCAHR)foresophagealcancer.MethodsEightytwopatientswererandomlydividedintotwogroups：41patientsinthetreatmentgroupreceivedcapecitabinecombinedwithLCAHR,andtheother41patientsinthecontrolgroupreceivedonlyLCAHR.Allpatientsweretrea

4、tedbyconventionalfractionatedradiotherapyduringthefirsttwothirdsofthewholecoursewith40?Gyin20fractions,followedbyLCAHRwith2530?Gyin1719fractions,1.5?Gyperfraction,twiceaday,withanintervalofmorethan6hoursbetweenfractionstoatotaldoseof6570?Gy.Thetreatmentgrouptook1?000?

5、mg/m2capecitabinetwiceadayforfourteendaysfollowedbya7dayrestperiodfromthefirstdayofradiotherapy,every3weeksasonecycle,totally2cycles.ResultsAllpatientscompletedtreatmentcourses.Theshorttermresponserateofthetreatmentgroupandthecontrolgroupwas89.7%and76.9%respectivelywith

6、statisticallysignificantdifferences.The1yearsurvivalratewas80.5%and73.2%inthetreatmentandcontrolgroupsrespectively(P＞0.05).Asforacuteradiationesophagitisandmyelosuppression,therewerenosignificantdifferencesbetweenthetwogroups.ConclusionsCapecitabinecombinedwithlatecourse

7、acceleratedhyperfractionatedradiotherapyforesophagealcancercanimprovetheshortterm10responserate.ItssideeffectsarenotstatisticallydifferentfromthoseofLCAHRaloneandaretolerable,howeveritslongtermresultsneedfurtherstudyintheclinic.　　Keywords：Esophagealneoplasms;Radiotherap

8、y;Drugtherapy;Dosefractionation单纯放射治疗食管癌的效果仍不十分理想，其5年生存率不足30%，失败的主要原因是局部肿瘤未控或复发，其次是淋巴结或远处转移［1］。后