贵州医科大学学报

2017, v.42;No.203(08) 952-956

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TP方案同步放化疗对非手术局部晚期食管癌的疗效
Clinical Efficacy of Concurrent Chemoradiotherapy as First-Line Treatment in Patients with Non-Eligible Locally Advanced Esophageal Carcinoma

赵骞;宁旭;
ZHAO Qian;NING Xu;Guizhou Medical University;Department of Orthopedics,the Affiliated Hospital of Guizhou Medical University;

摘要(Abstract):

目的:观察TP方案及FP方案同步放化疗一线治疗非手术局部晚期食管癌的临床疗效。方法:168例局部晚期食管癌患者,按其化疗方案分为TP组(n=80,多西他赛联合顺铂化疗)和FP组(n=88,5-氟尿嘧啶联合顺铂化疗),放疗剂量为54~66 Gy,1.8~2 Gy/次,5次/周;观察放化疗后两组完全缓解(CR)、部分缓解(PR)、稳定(SD)及进展(PD)患者例数,以CR+PR计算治疗有效率(RR),以CR+PR+SD计算疾病控制率(DCR);统计肿瘤远处转移率、患者无进展生存时间(PFS)、总生存期(OS)、1或2年生存率及不良反应。结果:TP组患者CR16例、PR36例,FP组CR 12例、PR 31例,TP组临床有效率(65.0%)高于FP组(48.9%),远处转移率(20.0%)低于FP组(35.2%),差异有统计学意义(P<0.05);TP组患者中位无进展生存时间(16.0个月)和总生存时间(13.2个月)低于FP组(29.3个月和24.0个月),差异有统计学意义(P<0.05);TP组患者1、2年生存率(81.3%和77.3%)高于FP组(57.5%和42.0%),差异有统计学意义(P<0.05);TP组骨髓抑制及神经毒性发生率高于FP组(P<0.05)。结论:与FP方案同步化疗比较,TP方案同步放疗治疗不能手术的局部晚期食管癌患者的临床有效率及远期生存率更高,肿瘤的远处转移率低。
Objective: To observe the efficacy of concurrent chemoradiotherapy( CRT) as first-line treatment in patients with locally advanced esophageal carcinoma( EC) who were not eligible for surgery. Methods: 168 patients with locally advanced EC were divided into TP group( n = 80,docetaxel combined with Cisplatin synchronous radiotherapy) and FP group( n = 80,5-synchronous radiotherapy of fluorouracil and Cisplatin). Total dose as 54 to 66 Gy,1. 8 to 2. 0 Gy/fraction radiation,5 times/week; observing CR,PR,SD and PD number of patients,calculating RR by CR + PR,calculating DCR by CR + PR + SD; count tumor distant metastasis rate,PFS,OS,survival rate and adverse reaction in 1 or 2 years. Conclusions: 16 CR cases,36 PR cases in TP group,12 CR cases,31 PR cases in FP group; clinical efficient rate of TP group( 65. 0%) was higher than FP group( 48. 9%),distant metastasis rate of TP group( 20. 0%) was lower than FP group( 35. 2%),differences were statistically significant( P < 0. 05). Progression-free survival of TP group( 16. 0 months) and overall survival of TP group( 13. 2 months) were lower than that of FP group( 29. 3 months and 24. 0 months),differences were statistically significant( P < 0. 05); 1 and 2 year survival rate of TP group( 81. 3% and77. 3%) was higher than FP group( 57. 5% and 42. 0%),differences were statistically significant( P< 0. 05); bone marrow suppression and nerotoxicity incidence rate of TP group were higher than FP group( P < 0. 05). Results: Comparing with FP approach,TP concurrent chemoradiotherapy was more effective and boasted higher survival rate in non-eligible locally advanced esophageal carcinoma with lower tumor distant metastasis rate.

关键词(KeyWords): 食管肿瘤;抗肿瘤联合化疗方案;放射治疗计划,计算机辅助;多西他赛;5-氟尿嘧啶;顺铂
esophageal neoplasma;antineoplastic combined chemotherapy protocols;radiotherapy planning,computer-assisted;docetaxel;5-fluorouracil;cisplatin

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作者(Author): 赵骞;宁旭;
ZHAO Qian;NING Xu;Guizhou Medical University;Department of Orthopedics,the Affiliated Hospital of Guizhou Medical University;

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DOI: 10.19367/j.cnki.1000-2707.2017.08.019

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