同步放化疗结合中医扶正治疗食管癌的临床研究

Combination of conformal radiotherapy,chemotherapy and traditional Chinese medicine in the treatment of esophageal carcinoma

127例食管癌患者随机分为单放组(RT组51例)、放化组(CRT组30例)和适形放疗加化疗结合中医扶正组(三联组46例)。单放组采用常规三野等中心放射治疗;放化组自常规放疗开始后第1、5周加用化疗;三联组采用适形放疗,自放疗开始后第1、5周加用化疗,同时放疗期间每日服用扶正升血煎剂。随访至2005年6月,单放组、放化组及三联组的骨髓抑制发生率分别为25.5%、90%和54.3%;急性放射性食管炎发生率分别为94.1%、96.7%和21.7%;放射性肺炎发生率分别为11.8%、26.7%和4%;完全缓解率分别为39.2%、66.7%和84.8%,部分缓解率分别为60.8%、33.3%和15.2%;1年生存率分别为43.1%、50%和71.7%;2年生存率分别为33.3%、40%和56.5%;3年生存率分别为13.7%、27%和39.1%。初步研究结果提示,适形放疗加化疗结合中医扶正治疗食管癌在提高患者生存质量、近期疗效及短期生存率方面明显优于单纯放疗及放化结合治疗,而且毒副反应较小。

One hundred and twenty seven patients with esophageal carcinoma were randomly divided into three groups. Group A-51 patients were given radiotherapy （RT group） ; Group B-30 patients were treated with conformal radiotherapy combined with chemotherapy （CRT group）. ;Group C-46 patients were treated with conformal radiotherapy combined with chemotherapy plus traditional Chinese medicine （Combined Group）. In Group A,Group B and Group C, the hematopoietic toxicity was observed in 25. 5%,90% and 54.3% of patients, respectively; Acute radiation esophagitis occurred in 94.1 %,96.7 % and 21.7 % of patients, respectively, the complete reponse rate （CR） was 39.2%, 66.7% and 84.8%,partial response（PR） was 60. 8%, 33. 3% and 15. 2%,respectively. The 1-,2-,3- year survival rates were 43.1 %, 50 % and 71.7 %, 33. 3 %, 40 % and 56.5 %, 13.7 %, 27 % and 39.1 %, respectively. The primary research results suggest that the conformal with radiotherapy combined with chemotherapy plus traditional Chinese medicine is superior to the radiotherapy alone or confomal radiotherapy combined with chemotherapy in improving the living quality , late curative effect, and 1-,2-year survival rates. The side-effects are tolerable.