放疗联合顺铂+氟尿嘧啶方案同步化疗治疗局部晚期食管癌的实效性探究

Research of radiotherapy combined with cisplatin and 5-fluorouraci concurrent chemoradiotherapy on locally advanced esophageal carcinoma

目的探讨放疗联合顺铂(cisplatin,DDP)加氟尿嘧啶(5-fluorouraci,5-FU)同步化疗对局部晚期食管癌的治疗效果。方法对河北医科大学第四医院2002年9月~2011年12月期间收治的80例局部晚期食管癌患者,分为联合组(n=40)和放疗组(n=40)。联合组行放疗同步采用DDP+5-FU联合治疗,放疗组只采用放疗法,对2组患者的疗效和治疗方法的安全性进行评价。结果放疗联合DDP+5-FU同步化疗治疗效果明显,治疗有效率达到90.0%,而只采用放疗治疗的有效率只有72.5%,2者有显著差异(P<0.01)。联合组患者2年生存率为33%,大于放疗组的24.4%,差异具有统计学意义(P<0.05)。治疗过程中联合组出现恶心呕吐、骨髓抑制、食管炎、放射性脑病等不良反应较放疗组高,但绝大多数反应较轻,经积极治疗可消除。结论放疗联合DDP+5-FU同步放疗能够有效提高局部晚期食管癌患者的近期疗效及生存率,引发的不良反应有增加,但仍能被有效控制。

Objective To study the efficacy of radiotherapy combined with cisplatin and 5-fluorouraci concurrent chemoradiotherapy on locally advanced esophageal carcinoma. Methods 80 cases with locally advanced esophageal carcinoma collected in our hospital from September 2002 to December 2011 were divided into combination group and radiotherapy group, each had 40 cases. Patients of combination group were given radiotherapy combined with DDP and 5-FU, while radiotherapy group were only adopted radiation therapy. The efifcacy and the safety of the therapy methods were evaluated. Results The treatment effect of the chemoradiotherapy on locally advanced esophageal carcinoma was obvious. The efifcacy of combination group was 90.0%, and radiotherapy was only 72.5%, the difference was signiifcant(P<0.01). The survival rate of combination group was 33%, higher than 24.4%of radiotherapy group. The adverse reactions of combination group were higher than radiotherapy group, but most of which were light, and could be eliminated after active treatment. Conclusion The radiotherapy combined with DDP and 5-FU can enhance the efifcacy and survival rate of patients with locally advanced esophageal carcinoma, and also cause an increase in adverse reactions, which can be controlled effectively.