目的：比较甘氨双唑钠（ CMNa）联合同步放化疗（ CRT）治疗局部中晚期食管癌的疗效和毒副反应。方法2012年6月至2013年11月87例食管癌患者采用信封法随机分为CMNa＋CRT组（ n＝44）和CRT组（ n＝43）。调强放疗采用6 MV直线加速器，2．0Gy/次，每周5次，DT 50Gy。 CMNa＋CRT组放疗前0～3h给予CMNa 800mg/m2静滴，每周1、3、5给药，直至放疗结束。化疗采用顺铂（DDP）＋氟尿嘧啶（5-FU）方案：DDP 12．5mg/m2静滴，d1～d5；5-FU 450mg/m2静滴，d1～d5，28天为1周期，共2个周期。结果87例患者均可评价疗效。 CMNa＋CRT组获CR 31例，PR 8例，SD 4例，PD 1例，有效率为90．7％；CRT组获CR 25例，PR 7例，SD 9例，PD 2例，有效率为74．4％，两组有效率的差异有统计学意义（ P＝0．043）。两组毒副反应主要为1～2级骨髓抑制、肝功能异常、放射性食管炎和放射性肺炎，差异无统计学意义（ P＞0．05）。 CMNa＋CRT组和CRT组的1年生存率分别为90．0％和83．3％，差异无统计学意义（ P＞0．05）。结论 CMNa联合CRT治疗局部中晚期食管癌具有增敏作用，且不增加近期毒副反应。%Objective To evaluate the efficacy and side effects of sodium glycididazole( CMNa) combined with concurrent ra-diochemotherapy(CRT) for locally advanced esophageal cancer. Methods From June 2012 to November 2013, 87 patients pathologically confirmed as esophageal cancer were randomized into CMNa+CRT group(n=44) and CRT group(n=43). Radiotherapy was given by 6 MV X-ray on conventional schedule(2. 0Gy/f, 5 fractions a week, DT 50Gy). CMNa was given intravenously 800mg/m2, every Monday, Wednesday and Friday 0-3h before radiation. Chemotherapy regimen contained cisplatin 12. 5mg/m2 iv d1-d5 , and fluorouracil 450mg/m2 iv d1-d5 with 28 days of a cycle for 2 cycles. Results All patients were evaluable. Patients in CMNa+CRT group achieved 31 CR, 8 PR, 4 SD, 1 PD, and responce rate(RR) was 90. 7%;While in CRT group,patients got 25 CR,7 PR, 9 SD, 2 PD, and RR was 74. 4%. There were significant differences between RR of the two groups(P=0. 043). Main side effects were grade 1-2 bone marrow inhibition, hepatic dyfunction, radioactive esophagitis and radioactive pneumonia, with no differences(P>0. 05).The 1-year survival rates were 90. 0% and 83. 3% in CMNa+CRT group and CRT group with no differences( P>0. 05) . Conclusion CMNa combined with CRT for lo-cally advanced esophageal cancer can improve healing efficacy obviously and do not cause severe side effects.
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