三维适形放疗同步XELOX方案治疗食管癌术后局部复发的临床观察

Clinical observation of three-dimensional conformal radiotherapy combined with XELOX program for local recurrence after surgery of esophageal cancer

摘要:

目的：探讨三维适形放疗同步XELOX（奥沙利铂+卡培他滨）方案治疗食管癌术后局部复发的临床疗效。方法：将69例食管癌术后出现局部复发的患者随机分为治疗组和对照组。治疗组35例，给予三维适形放疗同步XELOX方案化疗；对照组34例，给予XELOX方案化疗。结果：治疗组和对照组患者一般资料比较差异无统计学意义。治疗组和对照组的客观有效率分别为85.7%和61.8%，两组比较差异有统计学意义（c2=5.130，P=0.024）。治疗组和对照组的1年生存率为65.7% 和 41.2%（c2=4176，P=0.041），2年生存率为45.7% 和20.6%（c2=4.900，P=0.027），两组的1年和2年生存率比较差异有统计学意义。治疗组恶心、呕吐及白细胞下降、贫血及血小板下降的发生率与对照组比较，差异无统计学意义（c2=0.206，P=0.650；c2=0.008，P=0.930；c2=0.174，P=0.676；c2=1.052，P=0.305）。结论：三维适形放疗同步XELOX方案化疗可提高食管癌术后局部复发患者的近期疗效和远期生存率，治疗毒副反应可以耐受。

Abstract:

Objective：To investigate the clinical efficacy of three-dimensional conformal radiotherapy combined with XELOX（oxali－platin+capecitabine） program chemotherapy for local recurrence after esophagectomy of esophageal cancer. Methods：A total of 69 cas－es with local recurrence after esophagectomy were randomly divided into treatment and control groups. In treatment group，35 patients received concurrent three-dimensional conformal radiotherapy and XELOX program chemotherapy. In control group，34 patients re－ceived XELOX program chemotherapy. Results：There was no statistically significant difference in general information between treat－ment group and control group. Response rates（RR） of treatment group and control group were 85.7% and 61.8%，with statistically sig－nificant differences（c2=5.130，P=0.024）. One-year survival rates of treatment group and control group were 65.7% vs. 41.2%（c2=4176，P=0.041），and 2-year survival rates of two groups were 45.7% vs. 20.6 %（c2=4.900，P=0.027），with statistically significant differences between two groups. There was no statistically significant difference in incidences of nausea，vomiting and leukopenia，anemia and thrombocytopenia between treatment group and control group（c2=0.206，P=0.650；c2=0.008，P=0.930；c2=0.174，P=0.676；c2=1.052，P=0.305）. Conclusions：Three-dimensional conformal radiotherapy concurrent with XELOX program chemotherapy can im－prove recent efficacy and long-term survival of patients with local recurrence after esophagectomy of esophageal cancer and reduce the side reactions.