ABSTRACT
Objective To evaluate the efficacy and toxicity of capecitabine combined with intensity modulated radiotherapy( IMRT)for postoperative mediastinal lymph node metastasis in esophageal cancer. Methods A total of 62 esophageal cancer patients with postoperative mediastinal lymph node metastases were randomly divided into the irradiation group(A group,31 cases)and the capecitabine combined with IMRT group( B group,31 cases). Both of two groups received IMRT radiotherapy with a total dose of 60-66 Gy, 30-33 times in 6-6. 5 weeks. The patients in B group were treated with capecitabine(1 250mg/ m2 ,2 f/ d, d1-d14,21 d × 2 cycle). Results Group A:there were 7 cases of complete response(CR),12 of partial response(PR),10 of stable disease(SD),and 2 of progressive disease(PD);the effective rate was 61. 3%(19 / 31). Group B:there were 10 cases of CR,16 of PR,4 of SD,and 1of PD;the effective rate was 83. 9%(26 / 31). There was a statistical significance between the effective rates of A group and B group(χ2 = 3. 971, P < 0. 05). Our experiment showed that the rates of grade Ⅱand Ⅲ myelosuppression in group A and group B were 29. 0% and 38. 7%(χ2 = 0. 648,P = 0. 421). The rates of Ⅰ and Ⅱ level radioactive pneumonia in group A and were 19. 4% and 25. 8%(χ2 = 0. 369,P = 0. 544). The different incidence of the two adverse reactions between group A and B had no statistical significance. Conclusion Compared with IMRT alone,IM-RT combined with capecitabine may have better curative efficacy without increasing toxicity to esophageal cancer patients with postoperative mediastinum lymphonode metastasis.