局部晚期食管癌同步放化疗疗效观察

The clinical observation of concurrent chemoradlotherapy on locally advanced esophageal carcinoma

目的探讨局部晚期食管癌同步放化疗疗效观察。方法73例局部晚期食管癌分为对照组和治疗组。37例对照组行单纯放疗：照射野按病灶部位向上下各延长3-5cm，胸上段及颈段包括双锁骨上区。在模拟定位机下设野定位，常规分割，即200cGy／次，5次／周，先照射4000cCy／20次，然后避脊髓放疗，总量达6400-7000cGy。36例治疗组：放疗同对照组，同时采用PF化疗方案，即顺铂20mg／d，5-FU500mg／d，静脉滴注1-5d，同时支持对症止吐等处理，28d为1周期，共化疗2周期。结果对照组近期有效率为73％，治疗组为89％。骨髓抑制方面，两组I度、Ⅱ度、Ⅲ度、Ⅳ度发生率分别为13.5％、18.9％、16.2％、0％和36.1％、27.8％、16.7％、2.7％。1、2、3年生存率分别为59.5％、35.1％、16.2％和80.5％、55.5％、19.4％。结论同步放化疗可提高近期疗效和1、2年的生存率，但骨髓抑制有明显增加的趋势。

Objective To evaluate the efficacy and toxicity of concurrent themoritherapy with locally advanced esophageal carcinoma. Methods 73 locally advanced esophageal carcinoma patients were divided randomly into two groups： the control group was radiontherapy only, all patients were irradiated 2.0Gy/per fraction , five fractions a week, the total radiation dose was 6400-7000cGy in tumor; the treatment group was concurrent chemoradiotherapy （5-FU 500 mg dl-5,DDP 20mg dl-4） Treatment was recycled every 28 days. Treatment responses were evaluated after 2 cycles according to WHO standard. Results The overall response rates of the control group and the treatment group was 73% and 89%, their 1-year, 3-year, 5-year overall survival rate was 59.5% 35.1% and 16.2% ;80.5% ,55.5% andl9.4%. The acute toxic effect was severer in the treatment group than the control group. Conclusion The better OS of locally advanced esophageal carcinoma a could be achieved with concurrent chemoradiotherapy compared with radiotherapy only statistically, while the toxicity of it is increasing.