老年局部晚期胃癌放疗作用初步研究

目的 比较替吉奥+放疗与单纯应用替吉奥在老年局部晚期胃癌患者中的疗效和耐受性。方法 选择不可手术切除的老年局部晚期胃癌(Ⅲ期)患者58例,随机分为替吉奥联合同步放疗组(试验组) 、单纯替吉奥组(对照组) 各29例。试验组给予替吉奥40 mg/m²口服2 次/d,第 1~14 天,休息1周后重复共4个周期,同时行胃部IMRT 45 Gy (1.8 Gy/次) ;对照组仅给予相同的替吉奥化疗。分别观察两组患者近期疗效及不良反应,并应用χ²检验差异。结果 58例患者完成计划设计。治疗完成时试验组和对照组客观缓解率、疾病控制率、症状缓解率分别为52%和24%、76%和45%、86%和48%(P=0.03、0.016、0.005)。两组患者恶心呕吐、厌食、白细胞减少、腹泻、血小板减少发生率相近(P>0.05)。结论 放疗+替吉奥治疗同步化疗对于老年局部晚期胃癌患者,提高了患者的近期疗效,且不良反应可接受。

The role of radiation therapy in the treatment of elderly patients with locally advanced gastric cancer

Objective To compare the efficacy and resistance between S-1 combined with radiotherapy and S-1 alone in the treatment of elderly patients with locally advanced gastric cancer. Methods Fifty-eight elderly patients with unresectable locally advanced (stage Ⅲ) gastric cancer were randomly and equally divided into S-1 combined with concurrent radiotherapy group (experimental group) and S-1 alone group (control group). The experimental group received 4 cycles of S-1 treatment with each cycle containing two-week oral administration of S-1 at a dose of 40 mg/m² twice a day followed by one-week drug withdrawal. Gastric intensity-modulated radiotherapy was performed concurrently with a dose of 45 Gy (1.8 Gy per fraction). The control group received the same dose of S-1 alone. Short-term outcomes and adverse reactions were evaluated in the two groups. Comparison was made by chi-square test. Results All patients completed the planning treatment. The experimental group had significantly higher objective response, disease control, and symptom remission rates than the control group (52% vs. 24%, P=0.03;76% vs. 45%, P=0.016;86% vs. 48%, P=0.005). There were no significant differences in the incidence of nausea and vomiting, anorexia, leukopenia, diarrhea, or thrombocytopenia between the two groups (all P>0.05). Conclusions S-1 treatment combined with concurrent radiotherapy improves the short-term outcomes and causes tolerable toxicities in the treatment of elderly patients with locally advanced gastric cancer.