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目的评价局部晚期胸中上段及胸上段食管癌患者用替吉奥(S-1)和顺铂方案同步调强放疗的临床疗效及安全性。方法 46例局部晚期胸中上段及胸上段食管癌患者接受替吉奥+顺铂化疗同步放疗,替吉奥60 mg·m-2·d-1,分2次口服,连服14 d后休息7 d;顺铂75 mg·m-2,分3 d注射。21 d为1周期。放疗方案:每天2 Gy,共60 Gy。放疗期间给予2周期化疗,放疗结束后予以原方案辅助化疗2周期。观察患者的临床疗效、生存时间及不良反应。结果确诊时原发病灶4期(T4)患者26例(占56.5%),区域淋巴结1期(N1)患者30例(占65.2%)。治疗后,患者临床有效率为67.4%,2年无疾病生存率为45.2%,总生存率为54.2%;2级以上不良反应主要为放射性食管炎(28.3%)及白细胞减少(37.0%),且无治疗相关死亡事件发生。结论替吉奥+顺铂方案同步调强放疗治疗局部晚期胸中上段及胸上段食管癌临床有效率高,且不良反应可控。
Objective To evaluate the clinical efficacy and safety of synchronous intensity modulated radiotherapy (I-G) and cisplatin regimen in patients with esophageal cancer in the upper thoracic and upper thoracic segments. METHODS: Forty-six patients with locally advanced thoracic upper esophageal cancer and esophageal cancer underwent esophagectomy for the treatment of esophageal cancer. The patients were treated with 60 mg · m-2 · d-1 of tegaserod and cisplatin simultaneously for 2 times. d; cisplatin 75 mg · m-2, in 3 d injection. 21 d for 1 cycle. Radiotherapy options: 2 Gy per day for a total of 60 Gy. 2 cycles of radiotherapy given chemotherapy, radiotherapy after the end of the original program adjuvant chemotherapy 2 cycles. To observe the clinical efficacy, survival time and adverse reactions in patients. RESULTS: Twenty-six patients (56.5%) had primary lesion in stage 4 (T4) and 30 patients (65.2%) had stage N1 in regional lymph nodes. After treatment, the clinical effective rate was 67.4%, the 2-year disease-free survival rate was 45.2% and the overall survival rate was 54.2%. The grade 2 or more adverse reactions were mainly esophagitis (28.3%) and leucopenia (37.0%), And no treatment-related deaths occurred. Conclusions The combination of TIGO and cisplatin in the treatment of locally advanced thoracic upper esophageal cancer and esophagectomy of upper thoracic esophagus with high efficiency and controllable side effects.