卡培他滨联合三维适形放疗治疗老年中晚期食管癌的临床疗效观察

摘要

目的探讨卡培他滨联合三维适形放疗治疗老年中晚期食管癌的近期疗效及其不良反应.方法选择2010年12月至2012年10月我院收治的45例老年中晚期食管癌患者并将其随机分为两组：单纯放疗组22例(对照组),放疗同步卡培他滨组23例(试验组).对照组全程采用常规分割照射,1次/天,2 Gy/次,5次/周,总剂量60~66 Gy/30~33次/6~7周.试验组放疗方法同对照组,患者在放疗期间口服卡培他滨1000 mg·m-2,2次/天,连用14天后停药7天,21天为一个疗程,共治疗2个疗程.治疗结束后比较两组患者的临床疗效及其不良反应的发生情况.结果45例患者均按计划完成治疗,放疗结束后第8周复查,对照组和试验组的治疗总有效率分别为63.6%和82.6%,差异有统计学意义(P<0.05).试验组手足综合征及腹泻的发生率显著高于对照组(P<0.05),均为Ⅰ~Ⅱ级,两组其它不良反应如骨髓抑制、恶心、呕吐、放射性食管炎及放射性肺炎的发生率的差异均无统计学意义(P>0.05).结论相对于单纯放疗,卡培他滨联合三维适形放疗技术可提高老年中晚期食管癌的近期疗效,患者的不良反应有所增加,但患者均可耐受,值得临床进一步探讨.%Objective To observe the short-term clinical efficacy and adverse reaction of Capecitabine plus three-dimensional conformal radiotherapy in the elderly patients with Middle-advanced stage esophageal carcinoma. Methods From December 2010 to October 2012, 45 elderly patients with Middle-advanced stage esophageal carcinoma were randomized into three-dimensional con-formal radiotherapy (control group) and Capecitabine plus three-dimensional conformal radiotherapy (experimental group): the con-trol group had 22 patients and experimental group had 23 patients. Radiotherapy in both groups was similar. All patients in the two groups were treated with three-dimensional conformal radiotherapy (once per day, 2 Gy per fraction, 5 fractions per week with the total dose of 60 ~ 66 Gy/30 ~ 33 f / 6 ~ 7 w). The expermental group was received capecitabine (1 000 mg·m-2, twice per day, from the 1st to 14th day) for 2 cycles. The patient’s clinical efficacy and adverse reactions were compared between the two groups after 8 weeks. Results All of the 45 patients finished the planned treatment. The total effective rate was 63.6% in the control group and 82.6% in the expermental group, and the difference was statistically significant (P<0.05). Hand-foot syndrome and diarrhea incidence of the experimental group was significantly higher than that of the control group (P<0.05), which wereⅠ~Ⅱ grade. Other adverse reactions, such as bone marrow suppression, nausea, vomiting, radioactive esophagitis and radiation pneumonitis, had no significant difference between the two groups (P>0.05). Conclusions Compared with radiotherapy alone, Capecitabine plus three-dimensional conformal radiotherapy could improve the short-term efficacy in the elderly patients with Middle-advanced stage esophageal carci-noma, and could increase adverse reactions which patients can tolerate, therefore, it is worthy for further investigation.