目的：观察热疗联合化疗对中晚期食管癌患者的疗效及安全性。方法回顾分析我院2008年10月3日至2014年10月9日有明确病理的中晚期食管癌患者136例，按数字表随机原则分组的方法分为单纯化疗组（A 组）和化疗联合热疗组（B 组）。其中 A 组68例，给予紫杉醇175 mg／m2，静脉滴注，第1天，卡培他滨1000 mg／m2，口服，第1～14天，顺铂75 mg／m2，静脉滴注，分为第2～4天，21 d为1个周期，每例患者至少化疗2个周期；B组68例采用同样方案化疗，第1天同时配合全身热疗，使全身温度升至40～42℃，维持90 min。2个周期后观察A组和B组患者的近期疗效及毒副反应。结果 A组中完全缓解（CR）0例，部分缓解（PR）27例，稳定（SD）26例，进展（PD）15例，有效率（CR＋ PR）为39.7％；B组中CR 3例，PR 41例，SD 18例，PD 6例，CR＋PR为64.7％。2组比较差异有统计学意义（P＝0.003）。B组生活质量改善明显高于A组，差异有统计学意义（ P＝0.002）。Ⅲ度～Ⅳ度肝肾功能损害、骨髓抑制及消化道反应发生率A组分别为16.2％、23.5％及25.0％；B组分别为13.2％、20.6％及30.9％，差异均无统计学意义（肝肾功能损害 P＝0.628；骨髓抑制 P＝0.679；消化道反应 P＝0.444）。结论热疗联合化疗治疗中晚期食管癌，疗效确切，生活质量明显改善，安全性好，值得临床进一步研究和观察。%Objective To determine the therapeutic efficacy and security of hyperthermia combined with chemotherapy for advanced esophageal carcinoma .Methods One hundred and thirty‐six patients with locally ad‐vanced or metastatic esophageal carcinoma in the duration of Oct .3 ,2008 to Oct .9 ,2013 were enrolled into the study at random .Different chemotherapy regimens were applied in 136 patients with advanced esophageal carcino‐ma .Among them ,68 patients (Group A) receive chemotherapy through vein .The patients received paclitaxel 175 mg/m2 on day 1 ,Capecitabine 1 000 mg/m2 on day1‐14 and Cisplatin 75 mg/m2 on day 2‐4 of 21‐day course .The other 68 patients (Group B) received hyperthermia together with chemotherapy .Hyperthermia was maintained at 40‐42℃ for 90 min .We evaluated the efficacy and toxicity side‐effect after the patients received two courses .Re‐sults In Group A ,the rate of complete remission(CR) was 0 patient ,partial remission(PR) 27 patients ,stable disease(SD) 26 patients ,progressive disease (PD) 15 patients and the overall response rate (CR+ PR) was 39 . 7% ;while in Group B ,the corresponding figures were 3 ,41 ,18 ,6 and 64 .7% ,respectively .There were signif‐icant difference between the two groups (P=0 .003) .Life quality of B group was better than that of A group . There were significant difference between the two groups (P=0 .002) .The rate of grade Ⅲ﹢grade Ⅳ abnormal liver and kidney function ,myelosuppression and gastrointestinal tract reaction was 16 .2% ,23 .5% and 25 .0% in Group A ;while 13 .2% ,20 .6% and 30 .9% in Group B .No significant difference was found between them(P=0 .628 ,P=0 .679 ,P=0 .444) .Conclusion Hyperthermia combined with chemotherapy is efficient and safe for ad‐vanced esophageal carcinoma ,and is worthwhile for further study and observation in clinic .
展开▼
