| 龚伟廖洪张罗生贾彦征段宇新.调强适形放疗联合化疗治疗局部晚期食管癌的疗效观察[J].,2014,14(5):892-894 |
| 调强适形放疗联合化疗治疗局部晚期食管癌的疗效观察 |
| Observation on the Clinical Efficacy of Intensity Modulated RadiationTherapy (IMRT) Combined Chemotherapy in the Treatment of LocalAdvanced Esophageal Cancer |
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| DOI： |
| 中文关键词: 局部晚期食管癌 调强适形放疗 多西他赛 奈达铂 |
| 英文关键词: Local advanced esophageal cancer Intensity modulated radiation therapy Docetaxe Nedaplatin |
| 基金项目: |
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| 中文摘要: |
| 摘要目的：观察调强适形放疗(intensity modulated radiation therapy，IMRT)联合多西他赛、奈达铂方案化疗同步治疗局部晚期食管
癌的疗效及安全性。方法：选择66 例局部晚期食管癌患者为研究对象，将其随机分为2 组，其中常规放疗组（A 组）共30 例，采用
常规照射方法，6/8 MV 高能X 线，2.0 Gy/ 次，5 次/ 周；40 Gy/20 次后再次定位剂量达60～66 Gy，强调放疗组（B 组）共36 例，采
用强调适应性放疗，6/8MV-X 射线照射，以95％等剂量线包绕PTV（计划靶区），处方剂量GTV（肿瘤区）66 Gy/30 次，CTV（临床
靶区）60 Gy/30 次，PTV 60 Gy/30 次，每天1 次，每周5 次。强调放疗组同期接受IMRT 和多西他赛、柰达伯化疗，21 天1 个周期,
连续2 个周期。治疗结束后根据实体瘤疗效评价标准（RECIST）评定临床疗效；参照WHO 毒性反应分度标准评价毒副反应。结
果：常规放疗组和强调放疗组的总有效率分别为46.66%和91.67％（x2=17.26，P<0.05）；常规放疗组的毒副反应发生率显著高于强
调放疗组，包括骨髓抑制、放射性食管炎和消化道反应的发生率存在显著差异（P<0.05）。结论：调强适形放疗联合多西他赛、奈达
铂化疗同步治疗局部晚期食管癌疗效较好，毒副反应可耐受，具有潜在的推广应用价值，值得临床进一步研究。 |
| 英文摘要: |
| ABSTRACT Objective:To observe the clinical effects of intensity modulated radiation therapy (IMRT) combined docetaxe and
nedaplatin chemotherapy for local advanced esophageal cancer.Methods: Totally 66 patients with local advanced esophageal cancer were
enrolled in this study. Thirty patients enrolled in group A (n=30) received conventional radiotherapy. External beam radiation of
6/8MV-X ray was given 2.0 Gy/time and 5 time / week. A total dose of 60-66 Gy was reset after 40 Gy/20 times. Thirty-six patients enrolled
in groupB (n=36) received IMRT with external beam radiation of 6/8MV-X ray and PTV received 95% of total dose radiation.
GTV received a dose of 66 Gy/30 times, CTV received a dose of 60 Gy/30 times and PTV received a dose of 60 Gy/30 times. Patients
were treated once a day and 5 times/week and combined with docetaxe and nedaplatin chemotherapy. After two cycles of chemotherapy,
the clinical efficacy was evaluated according to the standards of response evaluation criteria in solid tumors (RECIST); toxic side effects
were measured referring to the standards of WHO. Results: The clinical efficacy of all the patients could be evaluated, of which the total
effective rate was 46.66%in group A and 91.67%in groupB (x2=17.26, P＜0.05). The main toxic and side effects included myelosuppression,
radiation esophagitis and digestive tract reactions, which were all significantly severer in group A than those in group B (P<0.
05).Conclusion: IMRT combined docetaxe and nedaplatin chemotherapy has shown satisfactory efficacy and safety in treating local advanced
esophageal cancer which has the potential for extensive application and is deserved further clinical research. |
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