放疗联合奈达铂及热疗治疗中晚期食管癌的临床观察

摘要

目的 观察三维适形放疗、周剂量奈达铂增敏、体外高频热疗相结合,治疗中晚期食管癌的疗效.方法 选择2010年1月至2012年5月于河北省承德市第三医院肿瘤科治疗的中晚期食管癌患者99例,采用随机数字表法分为放化疗标准组、放化疗试验组、放化热疗试验组,各33例.治疗结束后1个月评估近期疗效和近期不良反应,随访结束后评估1年生存率.结果 放化疗标准组有效率为66.7％(22/33),放化疗试验组为63.6％ (21/33),放化热疗试验组90.9％ (30/33),3组有效率比较差异有统计学意义(P＜0.05).放化疗标准组1年生存率为54.5％ (18/33),放化疗试验组为57.6％(19/33),放化热疗试验组为81.8％(27/33),3组比较差异有统计学意义(P＜0.05).放化热疗试验组,体重增加占78.8％(26/33),卡氏评分增加占81.8％(27/33),与放化疗试验组[体重增加占60.6％(20/33),卡氏评分增加占69.7％(23/33)]、放化疗标准组[体重增加占54.5％(18/33),卡氏评分增加占75.8％(25/33)]比较差异无统计学意义(P＞0.05).放化热疗试验组放射性食管炎发生率为81.8％ (27/33),与放化疗标准组100.0％(33/33)比较差异有统计学意义(P＜0.05).结论 三维适形放疗、周剂量奈达铂增敏、体外高频热疗相结合,治疗中晚期食管癌有效率和1年生存率提高,不良反应可以耐受.%Objective To observe the effect of three-dimensional conformal radiotherapy in combination with weekly dose of nedaplatin and extracorporeal high-frequency hyperthermia on advanced esophageal carcinoma.Methods Ninety-nine cases of patients with advanced esophageal carcinoma in the third hospital of Chengde from January 2010 to May 2012 were selected.Ninety-nine cases of advanced esophageal carcinoma were randomly divided into the standard chemoradiotherapy group (33 cases),the experimental chemoradiotherapy group(33 cases)and the experimental hyperthermochemoradiotherapy group (33 cases).One month after treatment,the response rate and recent adverse effects and one-year survival rate were evaluated.Results Response rate of the standard chemoradiotherapy group was 66.7％ (22/33).Response rate of the experimental chemoradiotherapy group was 63.6％ (21/22).Response rate in the experimental hyperthermochemoradiotherapy group was 90.9％ (30/33).The experimental hyperthermochemoradiotherapy group was statistically different from other groups (P ＜ 0.05).One year survival rate of the standard chemoradiotherapy group was 54.5％ (18/33).One year survival rate of the experimental chemoradiotherapy group was 57.6％ (19/33).One year survival rate of the experimental hyperthermochemoradiotherapy group was 81.8％ (27/33).The experimental hyperthermochemoradiotherapy group was statistically different from other groups (P ＜ 0.05).The experimental hyperthermochemoradiotherapy group dysphagia reduce accounted for 87.9％ (29/33),which was higher than other groups (P ＜ 0.05) ; Weight gain accounted for 78.8％ (26/33)and KPS score gain accounted for 81.8％ (27/33).The esophagitis incidence of the experimental hyperthermochemoradiotherapy group was 81.8％ (27/33),which was higher than that of the standard chemotherapy group (P ＜ 0.05).The incidence rate of nausea and vomiting of the standard chemotherapy group was statistically different from other groups (P ＜ 0.05).Conclusion The treatment of three-dimensional conformal radiotherapy in combination with extracorporeal high-frequency hyperthermia is effective for advanced esophageal carcinoma.