| 王洪智,张扬子,耿建昊,朱向高,李永恒,蔡勇,王维虎.容积旋转调强放疗联合化疗治疗肛管鳞癌的疗效分析[J].中华放射医学与防护杂志,2019,39(8):609-613 |
| 容积旋转调强放疗联合化疗治疗肛管鳞癌的疗效分析 |
| Efficacy of volumetric intensity modulated arc therapy (VMAT) combined with chemotherapy in anal squamous cell carcinoma |
| 投稿时间：2019-05-28 |
| DOI：10.3760/cma.j.issn.0254-5098.2019.08.009 |
| 中文关键词: 肛管鳞癌 容积旋转调强放疗 同步化疗 疗效 不良反应 |
| 英文关键词:Anal squamous cell carcinoma Volumetric intensity modulated arc therapy Concurrent chemotherapy Efficacy Toxicity |
| 基金项目:首都临床特色应用研究专项（Z181100001718192） |
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| 中文摘要: |
| 目的 探讨调强放疗时代，肛管鳞癌同步放化疗的疗效及影响因素。方法 收集本院2011年以来接受根治性放疗的肛管鳞癌患者19例，回顾性分析该组患者的生存情况及其影响因素。结果 中位随访时间31个月，3年无局部复发生存和总生存分别为88.1%和91.7%。放化疗期间3级不良反应主要表现为白细胞减低（15.8%）、血小板减低（10.5%）、腹泻（15.8%）、皮肤反应（31.6%）。与历史数据对比，容积旋转调强放疗在肛管鳞癌的治疗中疗效和不良反应方面优于常规放疗。单因素分析显示，对比含5-FU的同步化疗方案，应用含卡培他滨的同步化疗可能是控制肿瘤进展的有利因素（P<0.05）。结论 调强技术放疗治疗肛管鳞癌在疗效和正常组织保护方面可能更有优势，同步化疗采用含卡培他滨的双药方案可能是降低肿瘤进展的有利因素。 |
| 英文摘要: |
| Objective To investigate the efficacy of concurrent chemoradiotherapy for anal squamous cell carcinoma (ASCC) in the era of intensity-modulated radiotherapy. Methods A total of 19 patients with ASCC who underwent definitive radiotherapy in our hospital since 2011 were collected. The survival curves were depicted with K-M method. Risk factors of disease progression were analyzed using case-control study. Results The median follow-up time was 31 months. The 3 year-LFS and 3 year-OS were 88.1% and 91.7%, respectively. Grade 3 acute toxicities during the chemoradiotherapy were mainly white blood cell reduction (15.8%), platelet reduction (10.5%), diarrhea (15.8%), and skin reaction (31.6%). Compared with historical data, volumetric intensity modulated arc therapy was superior to conventional radiotherapy in the treatment outcome and normal tissue protection in ASCC. Univariate analysis showed that concurrent chemotherapy with capecitabine was a favorable factor in disease progression (P<0.05). Conclusions Volumetric intensity modulated arc therapy for ASCC may have advantages in terms of efficacy and normal tissue protection. Concurrent chemotherapy with a double-drug regimen containing capecitabine may be a beneficial factor in disease progression. |
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