赵鑫

[摘要] 目的 探究雷替曲塞联合放化疗对局部晚期食管癌的临床治疗效果，观察患者的生存质量情况。方法 方便选择2015年5月—2016年2月期间，该院收治的48例局部晚期食道癌患者（包括IIIB-IVA期）为该次研究对象，将其按照随机分组法分为研究组和对照组，每组24例患者，所有患者同步放疗均采用三维适形放疗，常规分割剂量为2 Gy/d，每周放疗5 d，放疗总剂量60 Gy.研究组同步应用雷替曲塞联合奈达铂化疗，对照组行顺铂化疗。观察两组治疗效果及生存质量情况。结果 两组患者临床治疗效果对比，研究组总缓解率为91.6%，对照组总缓解率为79.10%，差异有统计学意义（χ2=6.258，P=0.014）。两组患者生存质量状况对比，身体生理机能、食道疼痛情况差异无统计学意义（P>0.05），精神、精力、心理，社会功能、情感职能相比，研究组优于对照组（P>0.05）。两组不良反应状况对比，研究组发生状况均低于对照组，对比差异有统计学意义（P<0.05）。两组患者生存率对比，研究组优于对照组，对比差异有统计学意义（P<0.05）。 结论 雷替曲塞联合放疗方式对食管癌患者展开治疗，获得了良好的临床治療效果，有效提升了患者的生存质量。

[关键词] 雷替曲塞；放疗；食管癌；临床疗效；生存质量

[中图分类号] R735 [文献标识码] A [文章编号] 1674-0742（2018）06（c）-0133-03

[Abstract] Objective This paper tries to investigate the clinical efficacy of raltitrexed combined with chemoradiation in the treatment of locally advanced esophageal cancer and observe the quality of life of patients. Methods From May 2015 to February 2016， 48 patients with locally advanced esophageal cancer （including stage IIIB-IVA） who were admitted to the hospital were convenient included in this study. They were randomly divided into study group and control group， with 24 patients in each group， all patients received three-dimensional conformal radiation therapy for simultaneous radiotherapy. The conventional dose was 2 Gy/d. Radiotherapy was given for 5 d every week. The total dose of radiation therapy was 60 Gy. The study group received simultaneous use of raltitrexed with nedaplatin. For chemotherapy， the control group received cisplatin chemotherapy. Observe the treatment effect and quality of life of the two groups. Results Comparing the effects of clinical treatment between the two groups， the total remission rate in the study group was 91.6%， and the total remission rate in the control group was 79.10%. The difference was statistically significant （χ2=6.258，P=0.014）. There was no significant difference in the quality of life between the two groups （P>0.05）. The mental health， energy， psychology， social function， and emotional function of the two groups were superior to those of the control group. （P<0.05）. The incidence of adverse reactions in the two groups was lower than that in the control group. The difference was statistically significant （P<0.05）. The survival rate of the two groups was better than that of the control group. The difference was statistically significant（P<0.05）. Conclusion The combination of raltitrexed and radiotherapy in the treatment of patients with esophageal cancer has achieved good clinical therapeutic effect and effectively improved the quality of life of patients.

[Key words] Raltitrexed； Radiotherapy； Esophageal cancer； Clinical efficacy； Quality of life

食管癌是一種严重影响人身体健康，对患者生命有严重威胁的消化系统恶性肿瘤，在我国具有较高的发病率[1]。临床收治的食管癌患者多数已经发展至中晚期，单独放疗治疗食管癌的总生存率较低，同步放化疗等非手术方式是临床治疗中晚期食管癌的常规方式，氟尿嘧啶（5-Fu）联合顺铂（DDP）是食管癌同步放化疗中经常联合的经典方案，但因其消化道反应、心脏毒性、肝肾毒性，部分患者难以耐受，治疗过程中生存质量情况不佳，患者治疗中常需暂停用药及调整标准治疗方案，影响患者疗效[2]。现今……