放化疗联合治疗中晚期食管癌的疗效观察

Clinical observation of combined chemoradiotherapy treatment on advanced esophageal carcinoma

目的 观察放化疗联合治疗中晚期食管癌的疗效及预后的相关因素.方法 回顾性分析60例中晚期食管癌患者,根据治疗方法 不同分为单纯放疗组(简称单放组)32例和放疗加化疗组(简称放化组)28例.放射治疗均采用6MV-X线常规照射,常规分割2 Gy/次,总量DT60～70 Gy,放化组在放射治疗同时或者放疗后给予顺铂(DDP)加亚叶酸钙(CF)加5-氟尿嘧啶(5-Fu)方案化疗.结果 放化组与单放组1、2、3年生存率分别为73.30%、46.70%、16.67%和60.30%、16.67%、6.67%;其中2年生存率放化组明显高于单放组,差异有统计学意义(P＜0.05).同期放化组与序贯放化组1、2、3年生存率分别为88.89%、55.55%、22.22%和84.21%、47.37%、15.79%.患者近期不良反应,放化组较单放组有所加重,差异有统计学意义(P＜0.05).治疗方式和临床分期是食管癌预后的影响因素(P＜0.05),放化联合较单纯放疗预后好,分期越晚预后越差.结论 放化疗联合能提高中晚期食管癌患者的2年生存率,患者近期不良反应可以耐受,是治疗中晚期食管癌有效的方法 之一.

Objective To observe the effect of radiotherapy and chemoradiotherapy in patients with esophageal cancer and analyze the associated factors of surviving with esophageal patients.Methods 60 cases were retrospectively analyzed in the study.They were divided into two groups according to the treatment methods,radiotherapy(RT)group and chemoraidiotherapy(CRT)group.The group CRT was divided into concurrent chemoraidiotherapy(CCRT)group and sequence chemoraidiotherapy(SCRT)group.The group RT and group CRT all use 6mvX line conventional therapy,common fraction 200 Gy/f,DT 60 to 70 Gy,Group CRT combine the chemotherapy concurrent or after radiotherapy.Results The 1,2,3 year survival rate of the group CRT and the group RT are 73.30%,46.70%,16.67%and 60.30%,16.67%,6.67% respectively,2 year survival of group CRT is beaer than group RT(P＜0.05).(2)The 1,2,3 year survival rate of the group SCRT and CCRT are 88.89%,55.55%,22.22% and 84.21%,47.37%,15.79% respectively.The short-term side-effect is more serious,the patients could bear.The prognosis of the esophageal carcinoma is closely associated with treatment methods and clinical stage.Conclusion Chemotherapy combined with radiotherapy for advanced esophageal cancer improved the survival.Chemoradiotherapy is an effective treatment for advanced esophageal carcinoma,diagnosis and treatments in early stage are especially important.