| 刘华,蒋祥德,张华鹏,等.调强放疗联合替吉奥治疗老年Ⅲ期未手术食管鳞癌的疗效观察[J].安徽医药,2017,21(9):1683-1687. |
| 调强放疗联合替吉奥治疗老年Ⅲ期未手术食管鳞癌的疗效观察 |
| Clinical observation of S-1 combined with IMRT for the treatment of elderly patients with stage Ⅲ esophageal squamous cell carcinoma without surgeryLIU Hua1,JIANG Xiangde1,ZHANG Huapeng1,CHENG Gang1,CHEN Fang1,PAN Tengli1,LI Gujun1,QIAN Liting2(1.Department of Oncology,People′s Hospital of Bozhou,Bozhou,Anhui 236000,China; 2.Anhui Provincial Cancer Hospital,Hefei,Anhui 230000,China) Abstract:Objective |
| 投稿时间：2017-01-18 |
| DOI： |
| 中文关键词: 食管癌 调强放疗 不良反应 |
| 英文关键词: Esophageal neoplasm Intensity-modulated radiotherapy Adverse reactions |
| 基金项目: |
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| 中文摘要: |
| 目的 调强放疗联合替吉奥的方案治疗老年Ⅲ期未手术食管鳞癌,观察近期疗效、毒性反应、毒性反应、总生存期以及1、2、3年的生存率。 方法 30例初治的年龄＞65岁的Ⅲ期未手术食管鳞癌患者均接受调强放疗,采用6mV-X 线外照射,处方剂量为50～60 Gy,每次的照射剂量为1.8~2 Gy,1周5次,分25～33次5～6.5周完成。在调强放疗的同时口服替吉奥化疗,根据体表面积＜1.25 m2,80 mg·d-1；体表面积1.25～＜1.50 m2,100 mg·d-1；体表面积≥1.50 m2,120 mg·d-1,2次/天,餐后0.5 h口服,连续口服2周,休息1周,3周为1个疗程,至少持续半年。 结果 完全缓解23例(76.7%),部分缓解5例(16.7%),总有效率 93.3%；治疗过程主要毒副反应放射性食管炎、放射性肺炎、胃肠道反应的发生率分别为60.0%、16.7%、50.0%,血液毒性中白细胞减少、血小板下降、血红蛋白减少发生率分别为60.0%、53.3%、23.3%。1、2、3年累计生存率分别为73.3%、56.7%、46.7%。全组患者的中位生存期为32.5个月,研究发现血红蛋白等指标的变化与生存率有关联关系。 结论 替吉奥联合调强放疗治疗可以提高老年Ⅲ期未手术食管鳞癌近期和远期生存率,同时还发现血红蛋白的水平可作为判断新的食管癌的预后因素之一。 |
| 英文摘要: |
| Objective To observe short-term efficacy,toxicity,overall survival,and 1st,2nd,and 3rd year survival rates of the treatment of IMRT plus S-1 on the elderly patients of stage Ⅲ esophageal squamous cell carcinoma without surgery. Methods Thirty cases with initial-treatment age above 65 were treated with IMRT,using 6mV- X-ray irradiation,50-60 Gy of the prescription dose with 1.8-2 Gy for each,5 times a week,25-33 times within 5-6.5 weeks.Oral therapy of S-1 was given simultaneously,80 mg·d-1 for less than 1.25 m2 of the body surface area,100 mg·d-1 within the range of body surface area from 1.25 to 1.50 m2,0 mg·d-1 for larger than 1.50 m2of the body surface area.The medicine was taken twice a day,half an hour after meal within a 3-week course by taking the dose for consecutive 2 weeks and resting for 1 week,for less than half a year at least. Results The overall response rate was 93.3% with 23 cases of complete remission (76.7%) and 5 cases of partial remission (16.7%).During the treatment,the main side reactions were radiation esophagitis (60.0%),radiation pneumonitis (16.7%),radiation gastrointestinal reaction (50.0%),and hematological toxicity (leukopenia,60.0%;thrombocytopenia,53.3%;hemoglobin reduction,23.3%).The 1st,2nd,and 3rd year cumulative survival rates were 73.3%,56.7%,and 46.7%,respectively.The median survival time was 32.5 months in the whole group,and it was found that the changing of hemoglobin was related to the survival rate. Conclusions S-1 combined with IMRT treatment can increase recent effective rate and long-term survival rate for the stage Ⅲ esophageal squamous cell carcinoma without surgery.And it was also found that the changing in hemoglobin could be used as a new prognostic factor of esophageal cancer. |
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