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洛铂联合5-氟尿嘧啶同步放疗治疗不可切除食管癌的临床研究

Clinical Study on Lobaplatin Combined with 5-Fu and Concurrent Radiotherapy in Treating Patients with Inoperable Esophageal Cancer.

作者信息

Jia Xiao-Jing, Huang Jing-Zi

机构信息

Department of Tumor Radiationtherapy, the Second Hospital of Jilin University, Changchun, China E-mail :

出版信息

Asian Pac J Cancer Prev. 2015;16(15):6595-7. doi: 10.7314/apjcp.2015.16.15.6595.

Abstract

OBJECTIVE

To investigate short- and long-term treatment effects and side reactions of lobaplatin plus 5-Fu combined and concurrent radiotherapy in treating patients with inoperable middle-advanced stage esophageal cancer.

METHODS

Sixty patients with middle-advanced stage esophageal squamous cell cancer were retrospectively analyzed. All patients were administered lobaplatin (50 mg intravenously) for 2 h on day 1, and 5-Fu (500 mg/m2) injected intravenously from day 1 to 5 for 1 cycle, in an interval of 21 days for totally 4 cycles. At the same time, late-course accelerated hyperfractionated three-dimensional conformal radiotherapy was performed. Patients were firstly treated with conventional fractionated irradiation (1.8 Gy/d, 5 times/week, a total of 23 treatments, and DT41.4 Gy), and then treated with accelerated hyperfractionated irradiation (1.5 Gy, 2 times/d, a total of 27 Gy in 9 days, an entire course of 6-7 weeks, and DT 68.4 Gy).

RESULTS

All patients completed treatment, including 10 complete response (CR), 41 partial response (PR), 7 stable disease (SD), and 2 progressive disease (PD). The total effective rate was 85.0% (51/60). Thirty-nine patients had an increased KPS score. One-, 2-, and 3-year survival rates were 85.3%, 57.5%, and 41.7%, respectively. The median survival time was 27 months. The adverse reactions included myelosuppression, which was mainly degreeI and II. The occurrence rate of radiation esophagitis was 17.5%. No significant hepatic or renal toxicity was observed.

CONCLUSION

Lobaplatin plus 5-Fu combined with concurrent radiotherapy is safe and effective in treating patients with middle-advanced stage esophageal cancer. However, this result warrants further evaluation by randomized clinical studies.

摘要

目的

探讨洛铂联合5-氟尿嘧啶同步放化疗治疗无法手术的中晚期食管癌患者的近期及远期疗效和不良反应。

方法

回顾性分析60例中晚期食管鳞状细胞癌患者。所有患者于第1天静脉滴注洛铂(50mg)2小时,第1至5天静脉注射5-氟尿嘧啶(500mg/m²),1个周期,间隔21天,共4个周期。同时,进行后程加速超分割三维适形放疗。患者先接受常规分割照射(1.8Gy/天,每周5次,共23次,DT41.4Gy),然后接受加速超分割照射(1.5Gy,每天2次,9天共27Gy,全程6-7周,DT68.4Gy)。

结果

所有患者均完成治疗,其中完全缓解(CR)10例,部分缓解(PR)41例,疾病稳定(SD)7例,疾病进展(PD)2例。总有效率为85.0%(51/60)。39例患者KPS评分提高。1年、2年和生存率分别为85.3%、57.5%和41.7%。中位生存时间为27个月。不良反应包括骨髓抑制,主要为Ⅰ度和Ⅱ度。放射性食管炎发生率为17.5%。未观察到明显的肝或肾毒性。

结论

洛铂联合5-氟尿嘧啶同步放疗治疗中晚期食管癌患者安全有效。然而,这一结果有待随机临床研究进一步评估。

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