替吉奥联合3D-CRT与微波热疗治疗老年局部晚期食管癌的临床观察
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篇名: 替吉奥联合3D-CRT与微波热疗治疗老年局部晚期食管癌的临床观察
TITLE:
摘要: 目的:观察替吉奥联合三维适行放射治疗(3D-CRT)与微波热疗治疗老年局部晚期食管癌的临床疗效及安全性。方法:将48例局部晚期老年食管癌患者按随机数字表法分为A、B、C组,各16例。A组患者给予局部3D-CRT,总剂量60~66 Gy,共治疗6~7周;B组患者在A组基础上口服替吉奥60 mg/(m2·d),bid,3周为1个疗程,直到放疗结束;C组患者在B组基础上行微波热疗,3周为1个疗程,直到放疗结束。比较3组患者放疗结束后,临床疗效、1年生存率及吞咽困难、体质量、卡氏(KPS)评分变化情况,并观察3组患者主要毒副反应(放射性食管炎、放射性肺炎、胃肠道反应、骨髓抑制)发生情况。结果:C组患者总有效率为93.75%,1年生存率为87.50%,吞咽困难缓解率为93.75%。明显高于A组的50.00%、50.00%、56.25%和B组的68.75%、68.75%、68.75%,差异均有统计学意义(P<0.05)。3组患者体质量增加率及KPS评分增加率比较,差异均无统计学意义(P>0.05)。C组患者放射性食管炎、肺炎发生率均显著低于A组和B组,差异均有统计学意义(P<0.05);3组患者胃肠道反应、骨髓抑制发生率比较,差异均无统计学意义(P>0. 05)。结论:替吉奥联合3D-CRT与微波热疗能显著提高老年局部晚期食管癌的临床疗效和生存率,且毒副反应相对较低。
ABSTRACT: OBJECTIVE: To observe clinical efficacy and safety of tegafur gimeracil oteracil potassium combined with 3D-CRT and microwave hyperthermia in the treatment of  elderly patients with local advance esophageal cancer. METHODS: 48 cases of local advance esophageal cancer were divided into group A, B and C according to random number table method, with 16 cases in each group according to random number table method. Group A was given 3D-CRT with total dose of 60-66 Gy totnlly for 6-7 weeks; group B was additionally given tegafur gimeracil oteracil potassium 60 mg/(m2·d), bid, on the basis of group A 3 weeks for a course of treatment, until the end of radvotherapy; group C was additionally given thermotherapy on the basis of group B 3 weeks for a course of treatment, until the end of radvotherapy.  Clinical efficacy, 1-year survival rate, dysphagia, weight and KPS score were compared among 3 groups, and the occurrence of toxic reactions (radioactive esophagitis, radioactive pneumonia, bone marrow suppression and gastrointestinal reaction) were observed in 3 groups. RESULTS: Total effective rate, 1-year survival rate and the remission rate of dysphagia of group C were 93.75%, 87.50% and 93.75%, which were significantly higher than those of group A (50.00%, 50.00% and 56.25%) and B (68.75%, 68.75% and 68.75%), with statistical significance (P<0.05). There was no statistical significance in the rate of weight gain and KPS score gain among 3 groups (P>0.05). The incidence of radioactive esophagitis and radioactive pneumonia in group C were significantly lower than in group A and B, with statistical significance (P<0.05); there was no statistical significance in the incidence of gastrointestinal reaction and bone marrow suppression among 3 groups (P>0.05). CONCLUSIONS: Tegafur gimeracil oteracil potassium combined with 3D-CRT and microwave hyperthermia in the treatment of elderly patients with local advance esophageal cancer further improves clinical efficacy and survival rate, but shows low incidence of toxic reaction.
期刊: 2016年第27卷第26期
作者: 沙莎,霍明昌,王茂玉,李茂江
AUTHORS: SHA Sha,HUO Mingchang,WANG Maoyu,LI Maojiang
关键字: 替吉奥;微波热疗;三维适形放疗;局部晚期食管癌;疗效;毒副反应
KEYWORDS: Tegafur gimeracil oteracil potassium; Microwave hyperthermia; 3D-CRT; Local advance esophageal cancer; Efficacy; Toxic reaction
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