甘氨双唑钠联合同步放化疗治疗局部中晚期食管癌临床分析

摘要

Objective: To evaluate the effect of sodium glycididazole ( CM - Na ) combined concurrent radiotherapy and chemotherapy for locally advanced esophageal cancer. Methods: Total of 68 patients with locally advanced e-sophageal cancer were randomly divided into sensitized and control groups. Sensitization group, 34 patients with combined sodium glycididazole concurrent radiochemotherapy ( total dose of radiotherapy 60Gy - 68 Gy ); Chemotherapy regimens of 5 - FU + leucovorin + cisplatin; administration of CM - Na method: 800 mg/m2 , every Monday,Wednesday and Friday at 1 hour before radiochemotherapy . The control group:34 patients received concurrent radio-chemotherapy. Results: The recent effects: sensitization group CR, PR, NR and PD were 44. 1%( 15/34),47.0% ( 16/34 ),5. 9%( 2/34 ) and 2. 9%( 1/34 ),RR ( CR + PR ) was 90%( 31/34 );control group CR, PR, NR and PD were 29.4%( 10/34 ),47.0% ( 16/34 ), 17. 6% ( 6/34 )and 5. 9% ( 2/34 ), RR was 76. 5% ( 26/34 ). CR, NR and RR were significantly different ( P < 0. 05 ), but PR, PD were not different ( P > 0. 05 ) . Long - term effects: In sensitization group,1 year survival rate was 79. 4%( 27/34 ), 61. 8%( 21/34 ) in the control group;3 year survivalrate of sensitization group was 52. 9%( 18/34 ), 35. 3%( 12/34 ) in the control group. The difference was significant in 1,3 year survival rate between the two groups ( P <0. 05 ). Side effects: For was two groups, in the esophagitis, radiation - induced skin damage, gastrointestinal reactions, bone marrow suppression, liver and renal damage incidence there was no significant difference ( P > 0.05 ). Conclusion: CM - Na combined with concurrent radiochemotherapy for locally advanced esophageal cancer can improve efficacy and long - term survival rate is a safe regimen.%目的:评价甘氨双唑钠(CM-Na)联合同步放化疗治疗局部中晚期食管癌的临床疗效和不良反应.方法:68例局部中晚期食管癌患者随机分为增敏组和对照组.增敏组34例采用甘氨双唑钠联合同步放化疗(放疗总剂量60Gy-68Gy);化疗方案为5-氟尿嘧啶+顺铂+亚叶酸钙;甘氨双唑钠给药方法:800mg/m2,每周1、3、5于放化疗前1 小时内给药.对照组34例仅接受同步放化疗.结果:近期疗效:增敏组CR、PR、NR及PD百分比分别为44.1%(15/34)、47.0%(16/34)、5.9%(2/34)和2.9%(1/34),RR(CR+PR)为91.2%(31/34);对照组CR、PR、NR及PD百分比分别为29.4%(10/34)、47.0%(16/34)、17.6%(6/34)和5.9%(2/34),RR为76.5%(26/34),两组在CR、NR、RR差异显著(P<0.05),在PR、PD无差异(P>0.05).远期疗效:增敏组1年生存率为79.4%(27/34),对照组为61.8%(21/34);增敏组3年生存率为52.9%(18/34),对照组为35.3%(12/34),两组1、3年生存率差异显著(P<0.05).两组患者的放射性食管炎、放射性皮肤损伤、消化道反应、骨髓抑制及肝、肾功损害发生率,没有显著差异(P>0.05).结论:甘氨双唑钠联合同步放化疗治疗局部中晚期食管癌可提高近期疗效和远期生存率,安全性好,可进一步推广使用.