侯盘长+许妍+雒建超+等

侯盘长 许 妍 雒建超 王 伟 牛 坡

河南省人民医院放疗科，河南郑州 450003

[摘要] 目的 观察三维适形放疗同步替吉奥化疗治疗老年术后复发食管癌的近期疗效和毒副作用。 方法 37例老年食管癌术后复发患者，随机分为单放组（19例）和同步组（18例）。放疗应用三维适形放疗（2.0 Gy/次，5次/周，总剂量60～66 Gy）；同步组：放疗同步口服替吉奥胶囊化疗（40 mg/m2，2次/d，口服，连服14 d，21 d为1个周期）。观察两组疗效及不良反应。 结果 两组患者均完成治疗，依从性好。同步组有效率为83.0%，单放组有效率为68.4%，两组比较，差异有统计学意义（P < 0.05）。主要毒副作用为放射性食管炎、消化道反应、血液学毒性、放射性皮肤反应，多为1、2级。 结论 三维适形放疗同步替吉奥化疗治疗食管癌术后复发的疗效确切，毒副作用可耐受，能明显改善患者的生活质量。

[关键词] 食管肿瘤；放射疗法；三维适形；同期放化疗法；替吉奥

[中图分类号] R730.55 [文献标识码] A [文章编号] 1673-7210（2014）03（b）-0041-04

Efficacy observation of three-dimensional conformal radiation combined with S-1 treating for elderly postoperative esophageal

HOU Panzhang XU Yan LUO Jianchao WANG Wei NIU Po

Department of Oncology Radiotherapy， He'nan Provincial People's Hospital， He'nan Province， Zhengzhou 450003， China

[Abstract] Objective To observe the recent effect and side effect of three-dimensional conformal radiation combined with S-1 treating for elderly postoperative esophageal carcinoma. Methods 37 patients with elderly postoperative esophageal carcinoma were random divided into concurrent chemo-radiotherapy （CCRT） group （n = 18） and conventional radiotherapy alone group （CRT） （n = 19）. Both groups were treated with three-dimensional conformalradiation therapy （2.0 Gy/once， 5 times per week and the total dose was 60-66 Gy）. CCRT： the patients were given S-1 orally 40 mg/m2 twice/d for consecutive 14 days，and one cycle lasted for 21 days. The clinical effect and aduerse effect of the two groups were compared. Results All of the 37 patients' treatment were finished. The effective rate of CCRT and CRT were 83.0% and 68.4%， the difference was statistically significant （P < 0.05）. Major adverse effects were leukopenia， radiation esophagutis， anemia. Conclusion Three-dimensional conformal radiation combined with S-1 treating for elderly postoperative esophageal carcinoma has definite effect， high effective rate， patients show well tolerance， and without serious side effect. It can apparently improve the life quality of the patients.

[Key words] Esophageal carcinoma； Radiotherapy； 3-dimensionalconformal； Concurrent chemo-radiotherapy； S-1

我国是食管癌的高发国家，随着我国人口老龄化趋势，老年患者在食管癌的发病率构成比呈上升趋势。随着生活水平的提高，就诊的老年食管癌患者一般体质尚可，故外科手术仍是治疗食管癌的主要方法[1]，但患者仍常因术后复发和转移而死亡[2]。放射治疗是食管癌术后复发及局部转移的主要治疗手段，随着放射治疗设备、方法的更新，食管癌的放疗疗效有所提高，但预后仍不理想。因此，应用同步放化疗方案治疗复发性食管癌患者成为研究热点。本研究……