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目的比较盐酸依立替康+顺铂组成的方案与三维适形放射治疗(3DCRT)同步治疗与单纯放疗(3DCRT)治疗中晚期食管癌的近期疗效、毒副反应。方法 41例食管癌患者根据入选标准随机分组20例进入3DCRT+化疗组(放疗组),21例进入单纯3DCRT(单放组),化疗采用依立替康65mg/m2d1.8静脉滴注,顺铂(DDP)20mg/m2d1-5静脉滴注,21d为一周期,共化疗4～6周期,放化疗组3DCRT从化疗第一天开始,DT60-65Gy,分30-35次进行,6.0～6.5周完成,行第二周期化疗时放疗不间断。结果放化疗组与单放组完全缓解率分别为65%、52.4%,有效率(CR+PR)分别为85%、66.7%,1、2年局部控制率放化组分别为87.9%、76.8%,单放组分别为76.8%、59.2%。放化组毒副反应尤其是放射性食管炎、腹泻均大于对照组(P<0.05),但在Ⅲ、Ⅳ度反应方面两组无统计学差异(P>0.05),且患者能耐受。结论采用依立替康+顺铂方案化疗同期3DCRT治疗食管癌近期疗效和局部控制率较好,毒副反应增加但患者可以耐受。
Objective To compare the short-term effects and side effects of the combination of irinotecan hydrochloride and cisplatin with 3DCRT and simple radiotherapy (3DCRT) in the treatment of advanced esophageal cancer. Methods Forty-one patients with esophageal cancer were randomly divided into 3DCRT + chemotherapy group (radiotherapy group) and 21 patients with simple 3DCRT (radiotherapy alone group) according to inclusion criteria. The patients were treated with irinotecan 65mg / m2d1.8 intravenously and cisplatin DDP) 20mg / m2d1-5 intravenous infusion, 21d for a cycle of 4 to 6 cycles of chemotherapy, radiotherapy and chemotherapy group 3DCRT from the first day of chemotherapy, DT60-65Gy, 30-35 times, 6.0 to 6.5 weeks to complete , The second cycle chemotherapy radiotherapy without interruption. Results The complete remission rates of radiotherapy and chemotherapy group and single radiotherapy group were 65% and 52.4%, respectively. The effective rates (CR + PR) were 85% and 66.7% respectively. The local control rates of radiotherapy and chemotherapy group were 87.9% and 76.8% %, Single group were 76.8%, respectively, 59.2%. Radiotherapy group had more side effects, especially esophagitis and diarrhea than control group (P <0.05), but there was no significant difference between the two groups (P> 0.05). Conclusion The irinotecan + cisplatin chemotherapy with 3DCRT concurrent treatment of esophageal cancer in the short term efficacy and local control rate is good, increased side effects but patients can tolerate.