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超分割调强同步放化疗及辅助化疗治疗老年局部晚期食管癌的临床观察

罗云秀, 何安兵, 龙志雄, 袁希, 万欢, 郎锦义

罗云秀, 何安兵, 龙志雄, 袁希, 万欢, 郎锦义. 超分割调强同步放化疗及辅助化疗治疗老年局部晚期食管癌的临床观察[J]. 肿瘤防治研究, 2015, 42(08): 814-817. DOI: 10.3971/j.issn.1000-8578.2015.08.014
引用本文: 罗云秀, 何安兵, 龙志雄, 袁希, 万欢, 郎锦义. 超分割调强同步放化疗及辅助化疗治疗老年局部晚期食管癌的临床观察[J]. 肿瘤防治研究, 2015, 42(08): 814-817. DOI: 10.3971/j.issn.1000-8578.2015.08.014
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LUO Yunxiu, HE Anbing, LONG Zhixiong, YUAN Xi, WAN Huan, LANG Jinyi. Concurrent IMRT Hyperfraction Radiochemotherapy Combined with Adjuvant Chemotherapy on Elderly Patients with Locally Advanced Esophageal Cancer[J]. Cancer Research on Prevention and Treatment, 2015, 42(08): 814-817. DOI: 10.3971/j.issn.1000-8578.2015.08.014
Citation: LUO Yunxiu, HE Anbing, LONG Zhixiong, YUAN Xi, WAN Huan, LANG Jinyi. Concurrent IMRT Hyperfraction Radiochemotherapy Combined with Adjuvant Chemotherapy on Elderly Patients with Locally Advanced Esophageal Cancer[J]. Cancer Research on Prevention and Treatment, 2015, 42(08): 814-817. DOI: 10.3971/j.issn.1000-8578.2015.08.014
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超分割调强同步放化疗及辅助化疗治疗老年局部晚期食管癌的临床观察

  • 1. 430050 武汉，武汉市五医院肿瘤中心；2. 610041 成都，四川省肿瘤医院放疗中心

基金项目: 吴阶平医学基金（320.6750.12174）
详细信息
    作者简介:

    罗云秀（1976-），女，硕士，主治医师，主要从事肿瘤放射及综合治疗的研究

  • 中图分类号: R735.1

Concurrent IMRT Hyperfraction Radiochemotherapy Combined with Adjuvant Chemotherapy on Elderly Patients with Locally Advanced Esophageal Cancer

  • 1. Department of Oncology, Wuhan Fifth Hospital, Wuhan 430050, China; 2. Radiotherapy Center of Sichuan Province Cancer Hospital, Chengdu 610041, China

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    摘要
  • 摘要: 目的 观察超分割调强适形放疗同步奈达铂化疗+辅助化疗综合治疗老年局部晚期食管癌的近期疗效及不良反应。方法 回顾性分析52例局部晚期老年食管癌患者资料，观察组30例给予调强适形超分割放疗（64.4~75.9 Gy/56~66 F, 1.15 Gy/F, 2次/日, 每周5次）和奈达铂25~30 mg/m2同步化疗，卡培他滨辅助化疗（每天2 000~2 500 mg/m2）4~6周期。对照组22例给予常规分割调强适形放疗（52~60 Gy/26~30 F, 2 Gy/F, 1次/日, 每周5次）及奈达铂同步化疗及卡培他滨辅助化疗。结果 观察组28例（93%）患者经过同步放化疗后1月内吞咽梗阻缓解，中位生存时间29月，1、2、3年生存率87%、66%、25%。对照组16例（72%）放疗结束一月内吞咽梗阻缓解，中位生存期时间26月，1~3年生存率分别为83%、61%、22%。两组生存率差异无统计学意义（P=0.19），观察组和对照组无疾病进展中位生存时间分别为25月、20月，无疾病进展生存率差异有统计学意义（P=0.041）。不良反应两组差异无统计学意义。结论 超分割精确放疗和同步化疗及单药卡培他滨辅助化疗与常规分割调强放疗比较，未明显增加不良反应，有助于改善局部晚期老年食管癌早期梗阻症状和无疾病进展生存时间。

     

    Abstract: Objective To observe the short-term efficacy of concurrent IMRT hyperfraction radiochemotherapy combined with adjuvant chemotherapy on elderly patients with locally advanced esophageal cancer. Methods We retrospectively analyzed 52 elderly patients with locally advanced esophageal cancer. Thirty patients were grouped in observation group who were treated with concurrent hyperfraction IMRT (64.4-75.9Gy/56-66F, 1.15Gy/F, Bid, 5F/W) and concurrent chemotherapy Nedaplatin(25-30mg/m2/W), following 4-6 cycles of adjuvant chemotherapy with capecitabine(2 000-2 500mg/m2). Other 22 patients whose radiotherapy program was 52-60Gy/26-30F, 2Gy/F, Qd, 5F/W were divided into control group, and remaining treatment was same as observation group. Results In the observation group, the swallow obstruction of 28 patients were alleviated in one month after concurrent radiochemotherapy; the median survival time was 29 months; the 1-, 2- and 3-year survival rates were 87%, 66% and 25%, respectively. In the control group, the swallow obstruction of 16 patients were remitted; the median survival time was 26 months; the 1-, 2- and 3-year survival rates were 83%, 61% and 22%, respectively. The survival rate was not statistically different between two groups(P=0.19). Median survival time of progression-free survival were 25 and 20 months in observation group and control group (P=0.041). The adverse reactions between two groups were not statistically different. Conclusion Compared with routine fraction, concurrent hyperfraction radiochemotherapy combined with adjuvant capetabine chemotherapy help to remit early obstruction of elderly patients with locally advanced esophageal cancer and improve progression-free survival time without increasing adverse reaction.

     

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出版历程
  • 收稿日期:  2014-10-12
  • 修回日期:  2015-04-12
  • 刊出日期:  2015-08-24

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