【摘要】 [目的]研究替吉奥联合调强放疗治疗老年食管癌的疗效及不良反应。[方法]选择52例老年Ⅱ~Ⅲ期食管癌患者,随机分为替吉奥联合调强放疗组(放化疗组)26例和单纯调强放疗组(单放组)26例。两组患者均行调强放疗(IMRT)DT58~66Gy/29~33f,放化疗组在放疗第1天联合替吉奥化疗40mg/m2,一天2次,早、晚餐后口服,d1~14,休息7d,21d为1个周期,共2个周期。[结果]52例患者均可评价疗效。放化疗组的近期总有效率为84.6%,单放组为65.3%,差异无统计学意义(P>0.05)。放化疗组1、2年生存率为80.7%和57.6%,单放组1、2年生存率为57.6%和34.6%,差异均有统计学意义(P<0.05)。两组不良反应均以Ⅰ~Ⅱ反应为主,主要表现为骨髓抑制、消化道反应、放射性食管炎和放射性肺炎,两组比较差异无统计学意义(P>0.05),经处理后均能顺利完成治疗。[结论]替吉奥联合调强放疗治疗老年食管癌,虽然近期疗效差异不显著,但1、2年生存率有明显提高,而不良反应无明显增加,是老年食管癌较为理想可行的治疗方法,值得临床进一步推广。更多还原

【Abstract】 [Purpose] To investigate the efficacy and adverse sides of S-1 combined with intensitymodulated radiotherapy in the treatment for elder patients with esophageal cancer. [Methods]A total of 52 elder patients with esophageal cancer were randomized into two groups :26 patients treated with chemoradiotherapy and the other 26 patients treated with radiotherapy alone. The schedules of radiotherapy in two groups were intensity-modulated radiotherapy(IMRT) in conventional fractionation.The total dose was 58~66Gy/29~33f for all patients. Chemoradiotherapy group received S-1 treatment by 40mg/m2 bid after meals,since the first day of radiotherapy with chemotherapy simultaneously,and administration for 14 days followed by 7 days rest,while 21 days as a cycle. There were 2 cycles during radiotherapy. [Results] The efficacy of 52 patients could be evaluated. In the patients of chemoradiotherapy group,the short-term effective rate was84.6% while the radiotherapy alone group was 65.3%,with no statistic significance(P>0.05). The1-,2- year survival rates of chemoradiotherapy group were 80.7% and 57.6%,and the radiotherapy group were 57.6% and 34.6% respectively. The survival rates of the two groups had statistic significance(P<0.05).The major adverse sides in the two groups were myelosuppression,digestive tract reaction,radioation esophagitis and radioation pneumonitis,mainly grade 1 ~2.The adverse sides between the two groups showed no difference(P>0.05).[Conclusion] The short-term efficacy of S-1 combined with IMRT for elder patients with esophageal cancer is not improved,but the 1-,2- year survival rates of the two groups have statistic significance,and the adverse sides are not increased. So,it is an ideal,feasible method,and is worth to the clinical further promotion.更多还原