【摘要】 目的探讨替吉奥同期化放疗治疗局部晚期食管癌老年患者的临床疗效和不良反应。方法选择2011年1月-2013年3月我院放疗科收治的50例不宜或不愿手术的局部晚期食管癌老年患者,随机分为治疗组(替吉奥同期化放疗,n=25)和对照组(单纯放疗,n=25)。两组均采用全程调强适形放射治疗(IMRT)。治疗组在放疗开始同时口服替吉奥胶囊(一日80 mg/m2),一日2次,14 d为1个疗程,休息1周后再按原方案重复第2个周期,直至放疗结束,观察疗效和不良反应,并给予相应的护理。结果治疗组和对照组的近期总有效率分别为82.6%和62.5%;1年局部控制率分别为63.6%和43.5%;1年生存率分别为68.2%和39.1%,组间差异均有统计学意义(P<0.05)。治疗组不良反应主要表现为骨髓抑制、胃肠道反应、放射性食管炎和放射性肺炎等,经精心护理组间不良反应发生率差异无统计学意义。结论与单纯放疗相比,替吉奥同期化放疗治疗局部晚期食管癌老年患者近期疗效明显提高,结合精心护理可改善相关不良反应。更多还原

【Abstract】 Objective To evaluate the clinical effect and adverse reactions of concurrent chemoradiotherapy combined with oteracil potassium capsule(TS-1) for elderly patients with locally advanced esophageal cancer. Methods A total of 50 elderly patients with locally advanced esophageal carcinoma were randomly divided into treatment group(concurrent chemoradiotherapy combined with TS-1, n=25) and control group(radiotherapy alone, n=25). Intensity modulated radiation therapy(IMRT) was applied to two groups. The treatment group received an extra prescription of TS-1 with 80 mg/(m2·d), twice a day, and orally on day 1~14 with 21 days as a cycle, two cycles as a whole. Results The total effi ciency rates of treatment group and control group were 82.6% and 62.5%,the one-year local control rates were 63.6% and 43.5%, and the one-year overall survival rates were 68.2% and 39.1%, respectively. Statistical signifi cant differences were observed between two groups(P<0.05). The adverse reactions included bone marrow suppression, gastrointestinal reactions, radiation esophagitis and radiation pneumonitis. The incidence of adverse reactions was no signifi cant differences between two groups with careful nursing and appropriate treatment. Conclusion Remarkably improved short-term effi cacy is found in TS-1 combined concurrent chemotherapy in the treatment of the elderly patients with locally advanced esophageal cancer compared with radiotherapy alone. Although adverse reactions aggravate slightly, none is delayed for treatment due to intensive nursing.更多还原