放疗加卡铂治疗食管癌探查术后的临床研究

Clinical Studies on Radiotherapy Combined with or without Carboplatin on Treating Esophageal Cancers after Explored Operation

目的:探讨放射治疗加卡铂能否提高单纯探查术后食管癌的疗效。方法:86例单纯探查术后食管癌病例随机分为单纯放射治疗组(Ⅰ)和放射治疗加卡铂组(Ⅱ),每组分别为43例。Ⅰ组与Ⅱ组的照射方式和照射剂量相同;Ⅱ组,于放射治疗的第1和4周分别同时静脉滴注卡铂,剂量为AUC=90mg～150mg,连用4天。结果:Ⅰ组与Ⅱ组1、3、5年生存率分别为58.1%、14.0%,4.7%和79.1%、44.2%、23.3%,1、3、5年局部控制率分别为41.9%(18例)、11.6%(5例)、4.7%(2例)和76.7%(33例)、44.2%(19例)、23.3%(10例)。3、5年生存率、局部控制率比较差异有显著意义(P<0.05)。Ⅱ组20例(46.5%)发生1级、2级骨髓抑制,而Ⅰ组仅2例有1级骨髓抑制(4.7%),Ⅱ组的不良反应明显高于Ⅰ组(P<0.05)。结论:放射治疗同时加卡铂能提高食管癌探查术后的治疗疗效,不良反应增加,但可耐受。

Objective： To attempt the efficacy of combined radiotherapy and carboplatin in treatment of esophageal cancer after operative exploration. Methods： A total of 86 patients with esophageal cancer, after operative exploration, were randomly divided into two groups： group Ⅰ and group Ⅱ. Patients are randomized to one of the 2 treatment groups. The patients of group Ⅰ only receive radiotherapy. The patients of Group Ⅱ receive radiotherapy of identical doses and manners vs intravenous carboplatin AUC=90mg-150mg on four continuous days as one cycle in the first and fourth weeks of radiotherapy. Results： The 1-, 3- and 5-year survival rate of group Ⅰ and group Ⅱ was 74.4%, 14%, 4.7%和11 86%, 44.2% and 23.3%, respectively. The 3- and 5-year survival rate of group Ⅱ was higher than that in group Ⅰ （P〈0.05）. The 1-, 3-, and 5-year local control rate was 58.1%, 14%, 4.7% and 79.1%, 44.2%, and 23.3% respectively. The 3- year and 5-year local control rate of group Ⅱ was higher than group Ⅰ （P〈0.05）. As toxicity and side-effects, the occurrence of group Ⅱ was higher than Group Ⅰ（P〈 0.05）. A total of 20 patients in Group Ⅱ experienced reversed medulla depression, but only 2 in Group Ⅰ. Conclusion： Radiotherapy combined with carboplatin can obviously improve the 3- and 5-year survival rate of esophageal cancer after operative exploreation.