53例食管癌纵隔淋巴结转移致声嘶同步放化疗临床疗效分析73

53例食管癌纵隔淋巴结转移致声嘶同步放化疗临床疗效分析摘要】目的：探讨三维适形放疗同时给予紫杉醇联合顺铂化疗治疗食管癌术后

局部淋巴结转移声音嘶哑患者的疗效和毒性反应。方法：53例食管癌术后淋巴结转移伴有声音嘶哑的症状患者随机分成两组，研究组（同步放化疗组）28例和对照组（单纯放疗组）25例。研究组采用紫杉醇联合顺铂方案化疗，同时给予三维适形放疗，2Gy/次，5次/周，照射总剂量50-60Gy。对照组采用单纯三维适形放疗，放疗方法同研究组。结果：（1）53例患者均完成治疗。研究组声音嘶哑缓解率60.7%，对照组声音嘶哑缓解率40%。（2）放化疗毒性反应：研究组8例出现I-II级放射性气管炎,2例出现III-IV级放射性气管炎；4例出现I°-II°骨髓抑制,6

例出现III°-IV°骨髓抑制；4例出现I°-II°恶心呕吐消化道不良反应,3例出现III°-IV°消化道不良反应。而对照组中6例出现I-II级放射性气管炎,4例出现III-IV级放射性气管炎,3例出现I°-II°骨髓抑制,未出现III°-IV°骨髓抑制。对照组无明显消化道不良反应。结论：三维适形放疗同时给予紫杉醇联合顺铂化疗治疗食管癌术后纵隔淋巴结转移，安全有效，声音嘶哑缓解率高，毒性反映可以耐受，疗效优于单纯放射治疗。

【关键词】食管癌；淋巴结转移；三维适形放疗；同步放化疗

【中图分类号】R73 【文献标识码】A 【文章编号】2095-1752（2015）35-0043-02

53 cases of esophageal mediastinal lymph node metastasis to hearing chemoradiation clinical curative effect analysis Cui Yuelong, wang, zhang jh, Fanny Henan puyang city hospital in anyang region radiation Henan puyang 457000

【Abstract】Objective to investigate the three dimensional conformal radiation therapy with paclitaxel plus cisplatin chemotherapy in the treatment of esophageal cancer with hoarse local lymph node metastasis after curative effect and toxic reaction. Methods 53 cases with lymph node metastasis after esophagectomy were hoarseness symptoms of patients were randomly divided into two groups, group (group chemoradiation) 28 cases and the control group (simple radiotherapy group), 25 cases. Team with paclitaxel plus cisplatin chemotherapy, at the same time give three-dimensional conformal radiotherapy, 2 gy/times, five times per week, total dose irradiation 50-60 gy. Control group adopts simple three-dimensional conformal radiation therapy, radiation therapy with the team. Results (1) 53 patients completed treatment. Team hoarse remission rate 60.7%, control group hoarse response rate of 40%. (2) the radiation and chemotherapy toxicity reaction: team 8 cases appeared I - II level radioactive tracheitis, 2 cases of grade III - IV radioactive bronchitis; 4 cases appeared I ° - II ° bone marrow suppression, 6 cases with ° III - IV ° bone marrow suppression; 4 cases with gastrointestinal adverse reactions I ° - II ° nausea and vomiting, 3 cases with ° III - IV ° gastrointestinal adverse reactions. And 6 cases in control group I - II level radioactive tracheitis, 4 cases of grade III - IV radioactive tracheitis, 3 cases appeared I ° - II ° bone marrow suppression, does not appear ° III -

IV ° bone marrow suppression. The control group no significant gastrointestinal adverse reactions. Conclusion three-dimensional conformal radiation therapy with paclitaxel plus cisplatin chemotherapy treatment of mediastinal lymph node metastasis after esophagectomy, safe and effective, hoarse remission rate is high, reflect toxicity can be tolerated, curative effect was better than radiotherapy alone. 【Key words】Esophageal cancer, lymph node metastasis, The three dimensional