放疗联合化疗治疗食管癌90例临床效果观察

Study of clinical effects of radiotherapy combined with chemotherapy in treatment of esophageal carcinoma

目的比较单纯放疗和放疗联合化疗治疗食管癌的治疗效果。方法将90例食管癌随机分成对照组及综合治疗组。两组均采用三野放疗,200cGy/次,总剂量6400～6800cGy,综合治疗组先行卡铂(CBP)、5-氟尿嘧啶(5-Fu)、羟喜树碱(HCPT)方案化疗,再行放疗。结果综合治疗组局部控制率及1,3年生存率均高于对照组(P<0.05),综合治疗组急性胃肠道反应、骨髓抑制较对照组严重(P<0.05),两组晚期并发症差异无统计学意义(P>0.05)。主要晚期副作用是放射性食管狭窄和肺纤维化。结论综合治疗组能显著提高食管癌局部控制率与生存率,急性毒性增加,晚期反应无明显增加。

Objective To compare the efficacy and side effect of radiotherapy and radiotherapy combined with chemotherapy for esophageal carcinoma. Methods 90 patients with esophageal carcinoma were randomly divided into tow groups： control group 45 patients and combined therapy group 45 patients. Radiotherapy was performed on the control group, radiotherapy combined with chemotherapy which consisted of Carboplatin, 5-Fluorouracil and Hydroxycamptothecine were carried out the combined group. The two groups were under the same technical conditions and radiation dose. Three radiation fields were performed on both two groups at 200 cGy each time. The total radiation dose Were 6 400 - 6 800 cGy. Results The local tumor control rate of combined group were higher than control group markedly. The acute gastrointestinal tract reaction and myeflosuppression were more serious than the control group. However, the late radiation reaction were not significance between the two groups. The main late reaction were radiation esophageal stricture and lung fibrosis. Conclusion Radiotherapy combined with chemotherapy is able to enhance the local control rate, 1 year and 3 years survival rate for esophageal carcinoma, but the acute side effect also increased and the late reaction were not increased.