目的 探讨周剂量奈达铂同步后程加速超分割放疗联合体外高频热疗对局部晚期食管癌患者疗效及生存率的影响.方法 选取2010年6月～2012年9月河北省承德市肿瘤医院收治的60例晚期食管癌患者作为研究对象,采用随机数字表法将其分为观察组(30例)和对照组(30例),对照组采用周剂量奈达铂同步后程加速超分割放疗治疗,观察组采用周剂量奈达铂同步后程加速超分割放疗联合体外高频热疗治疗,比较两组患者临床疗效、生存率、生命质量,以及不良反应发生情况.结果 观察组有效率为86.6％(26/30),明显高于对照组的63.3％(19/30),差异有统计学意义(P＜0.05);观察组患者1、2、3年生存率分别为83.3％、63.3％、46.7％,对照组为76.7％、53.3％、43.3％,差异均无统计学意义(P＞0.05);观察组患者中位生存时间为21个月,对照组为18个月;两组组内治疗前后社会功能、情绪功能、躯体功能、总体症状评分比较差异有统计学意义(P＜0.05),且观察组治疗后社会功能、情绪功能、躯体功能评分明显高于对照组,总体症状评分明显低于对照组,差异有统计学意义(P＜0.05);两组患者放射性食管炎、放射性肺炎、恶心呕吐、骨髓抑制及皮肤反应发生率比较差异无统计学意义(P＞0.05).结论 周剂量奈达铂同步后程加速超分割放疗联合体外高频热疗治疗局部晚期食管癌有助于提高患者生活质量,且未增加不良反应发生,疗效显著,值得在临床上推广应用.%Objective To investigate the influence late course accelerated fractionated irradiation with weekly Nedaplatin combined with extracorporeal high-frequency hyperthermia on the effect and survival rate of patients with locally advanced esophageal cancer.Methods Sixty patients with locally advanced esophageal cancer admitted to Chengde Tumour Hospital from June 2010 to September 2012 were selected as the research objects,they were divided into the observation group (30 cases) and the control group (30 cases) by random number table.The control group was treated by late course accelerated fractionated irradiation with weekly Nedaplatin,the observation group was treated by late course accelerated fractionated irradiation with weekly Nedaplatin combined with extracorporeal high-frequency hyperthermia.The clinical efficacy,survival rate,quality of life and the conditions of adverse reactions between the two groups were compared.Results The effective rate of the observation group was 86.6％ (26/30),which was significantly higher than the control group [63.3％ (19/30)],the difference was statistically significant (P ＜ 0.05);the 1,2,3 year survival rate of the observation group was 83.3％,63.3％,46.7％ respectively,which of the control group was 76.7％,53.3％,43.3％ respectively,the differences were not statistically significant (P ＞ 0.05);the median survival time of the observation group was 21 months,which of control group was 18 months;the scores of social function,emotional function,physical function,overall symptom score within the two groups before and after treatment had significant differences (P ＜ 0.05),and the scores of social function,emotional function,physical function score of the observation group after treatment were significantly higher than those of control group,the overall symptom score was lower than that of control group,the differences were statistically significant (P ＜ 0.05);there were no significant differences in the incidence of radiation esophagitis,radiation pneumonitis,nausea and vomiting,bone marrow suppression and skin reaction of two groups (P ＞ 0.05).Conclusion The treatment of late course accelerated fractionated irradiation with weekly Nedaplatin combined with extracorporeal high-frequency hyperthermia in patients with locally advanced esophageal cancer can contribute to improve the quality of life,without increasing adverse reactions,which has significant curative effect.It is worthy to be popularized in clinical application.
展开▼
