【作者】 陈俊强； 潘建基； 李建成； 刘健； 朱坤寿； 陈明强； 王捷忠； 钱飞宇； 郑雄伟；

【Author】 CHEN Jun-qiang PAN Jian-ji LI Jian-cheng LIU Jian ZHU Kun-shou CHEN Ming-qiang WANG Jie-zhong QIAN Fei-yu ZHENG Xiong-wei

【机构】 福建医科大学教学医院福建省肿瘤医院放疗科； 福建医科大学教学医院福建省肿瘤医院内科； 福建医科大学教学医院福建省肿瘤医院胸外科； 福建医科大学教学医院福建省肿瘤医院病理科；

【摘要】 目的观察胸段食管鳞癌术后放化疗的毒副反应及对策。方法选择淋巴结阳性胸段食管鳞癌术后放化疗患者164例,术后放疗剂量50Gy,化疗方案为顺铂加紫杉醇,21天为一周期,观察其毒副反应。结果全组3年总生存率为65.7%,早期毒副反应主要表现:1、骨髓抑制主要为白细胞下降,其中Ⅰ/Ⅱ级125例(76.2%),Ⅲ/Ⅳ级33例(20.1%);2、脱发Ⅰ/Ⅱ级147例(89.6%);3、肌肉或关节痛Ⅰ/Ⅱ级97例(59.1%);4、胃肠道反应Ⅰ/Ⅱ级32例(19.5%),Ⅲ级6例(3.7%);5、全组无明显肝肾功能异常及过敏反应;6、放射性食管炎和放射性气管炎Ⅰ/Ⅱ级分别为61例(37.2%)和28例(17.1%)。晚期放疗损伤有肺损伤Ⅲ级8例(4.9%),肺损伤Ⅴ级1例(0.6%),吻合口狭窄1例(0.6%)。结论胸段食管鳞癌术后放化疗的毒副反应主要表现为白细胞下降、肌肉或关节痛和胃肠道反应,但患者能耐受治疗。更多还原

【Abstract】 Objective To investigate the toxic responses of postoperative chemoradiotherapy in thoracic esophageal squamous carcinoma.Methods 164 patients with thoracic esophageal squamous carcinoma and with positive lymph nodes underwent postoperative chemoradiotherapy.The irradiation dose was 50Gy.The chemotherapy consisted of cisplatin and paclitaxel,and one cycle continued 21 days.Results The overall 3-yeared survival rate was 65.7%.The early toxic responses mainly represented as following: (1).Myelotoxicity principally showed leucopenia at grade 1/2 occurred in 125 patients (76.2%) and at grade 3/4 in 33 patients (20.1%);(2).Baldness at grade 1/2 occurred in 147 patients (89.6%);(3).Pain of muscles or arthralgia at grade 1/2 occurred in 97 patients (59.1%);(4).Responses of gastrointestinal tract at grade 1/2 occurred in 32 patients (19.5%) and at grade 3 in 6 patients (3.7%);(5).There was no obvious liver and renal function abnormal and allergy.(6).Radiation induced esophagitis and tracheitis at grade 1/2 occurred in 61 patients (37.2%) and in 28 patients (17.1%) respectively.The late toxic responses of irradiation were pulmonary toxicity at grade 3 occurred in 8 patients (4.9%) and at grade 4 in one patients (0.6%),and stenostomia occurred in one patients (0.6%).Conclusion The toxic responses of postoperative chemoradiotherapy in thoracic esophageal squamous carcinoma mainly represented leucopenia,pain of muscles or arthralgia and responses of gastrointestinal tract,and they were tolerant.更多还原