论文部分内容阅读
目的观察三维适形放疗同期口服卡培他滨治疗局部晚期(不可手术)直肠癌患者的近期疗效及治疗的依从性。方法38例经病理证实的局部晚期(T4或局部-区域复发)的直肠癌患者接受了全盆腔三维适形放疗(3DCRT),DT46～50Gy/23～25F,后缩野至肿瘤区继续推量至DT64～66Gy/32～33F,同期接受卡培他滨(1650mg.m-2.d-1)治疗,分2次口服,第1～14天,每3周为1个周期,共服用2个周期。结果疗效评价:CR5例(13.2%),PR17例(44.7%),SD10例(26.3%),PD6例(15.8%),总有效率(CR+PR)57.9%;中位生存时间18.0个月,1年和2年总生存率分别为63.43%和18.78%。疼痛症状缓解率为100%;全身状况好转率52.8%。治疗相关的毒副反应以腹泻、中性粒细胞减少及手足综合征为主,其Ⅲ级反应的发生率分别为15.8%、15.8%和7.9%,均无Ⅲ级以上反应。结论3DCRT联合口服单药卡培他滨的同期放化疗方案是局部晚期(不可手术)直肠癌较好的治疗方法,其治疗的依从性高、毒副反应轻、近期疗效肯定、姑息性减症作用明显,值得临床推广应用。
Objective To observe the short-term curative effect and treatment compliance of three-dimensional conformal radiotherapy over capecitabine in patients with locally advanced (unresectable) rectal cancer. Methods 38 cases of locally advanced (T4 or local-regional recurrence) rectal cancer patients confirmed by pathology received 3DCRT, DT46 ~ 50Gy / 23 ~ 25F, DT64 ~ 66Gy / 32 ~ 33F, simultaneous capecitabine (1650mg.m-2.d-1) treatment, 2 times orally, 1 to 14 days, every 3 weeks for a cycle, taking a total of 2 cycle. Results Efficacy evaluation: CR5 (13.2%), PR17 cases (44.7%), SD10 cases (26.3%), PD6 cases (15.8%) and total effective rate (CR + PR) 57.9%; median survival time was 18.0 months The 1-year and 2-year overall survival rates were 63.43% and 18.78% respectively. Pain relief rate was 100%; general condition improvement rate of 52.8%. The treatment-related toxicities were mainly diarrhea, neutropenia and hand-foot syndrome. The incidences of grade Ⅲ reactions were 15.8%, 15.8% and 7.9% respectively, with no grade Ⅲ or higher response. CONCLUSIONS: The concurrent chemoradiotherapy with capecitabine in combination with 3DCRT and oral single-agent capecitabine is a good treatment for locally advanced (unresectable) rectal cancer with high adherence to treatment, mild toxic and side effects, positive efficacy in the near future, palliative reduction Significant role, it is worth promoting the clinical application.