常规放疗联合PLF方案治疗中晚期食管癌临床研究

A Clinical study of radiotherapy plus PLF regimen chemotherapy in the treatment of intermediate and advanced esophageal carcinoma

目的探讨PLF方案化疗合并常规放疗治疗中、晚期食管癌的临床应用价值。方法经病理确诊的中、晚期食管癌92例随机分为单放组和化放组，每组46例，放疗均采用6MVX线外照射，每次2Cy，5次／wk，共30-35次，总照射剂量60-70Gy。化放组静脉化疗运用PLF方案：顺铂（PDD）20mg／m^2，d1～d5；亚叶酸钙（LV）120mg／m^2，d1-d5；氟尿嘧啶（5．Fu）500mg／m^2，d1-d5，均静脉滴注，21d为1周期。治疗结束后，按照食管癌诊治规范标准，比较两组疗效及1年和3年生存率。结果单放组CR41．3％，PR52．2％，1年和3年生存率分别为41.3％，17-4％；化放组CR47．8％，PR50．0％，1年和3年生存率分别为71．7％，52．2％，两组生存率比较有显著的统计学意义（P〈0．05），毒副作用两组比较差异无统计学意义（P〉0．05）。结论PLF方案化疗合并常规放疗能明显提高中、晚期食管癌的近期疗效及1年和3年生存率，且不增加毒副反应，值得推广应用。

Objective To evaluate the effect of radiotherapy plus PFL regimen chemotherapy on the treatment of the intermediate and advanced esophageal carcinoma. Methods 92 patients with intermediate or advanced esophageal carcinoma were randomly allocated into two groups （single radiotherapy group and combined group）. The radiotherapy had been used the outer irradiation, which was five times a week, 2Gy per time, and 30-35 times in all. Total irradiation dosage was 60-70Gy. The vein chemotherapy was used PFL regimen, namely, cisplatin was used the intravenous drip for five days, 30mg per day, Lerfoline used before 5-fluorouracil for five days, 200mg per day, and 5-Fluorouracil used for five days, 750rag per day. One cycle was 21 days. The efficiency and 1- and 3- year survival rates between the two groups were studied. Results CR was 41.3% and PR was 52.2% in the single radiotherapy group, while CR was 47.8% and PR was 50.0% in the combined group. The 1-year survival rates in the single radiotherapy group and in combined group were 41.3% and 71.7%, the 3-years survival rates were 17.4% and 52.2%, vespeetively. There was significant difference between the two groups （P〈0.05）. The side-effect between the two groups was not significant difference. Conclusions The radiotherapy combined with PLF regimen chemotherapy is effective and well-tolerant.