局部晚期食管癌同步放化疗的临床分析

Clinical analysis of concurrent chemoradiotherapy for local advanced esophageal carcinoma

目的观察采用多西他赛、顺铂方案同步放疗治疗局部晚期食管癌的临床疗效和药物不良反应。方法68例局部晚期食管癌患者按就诊先后次序随机分成2组，同步放化疗组35例行放疗与化疗，放疗组33例仅进行放疗。2组均采用6MV—X线三野等中心常规放疗（DT64Cy／2Gy／32Fx）。同步放化疗组同时给予多西他赛40mg／m^2、顺铂20mg／m^2，静脉滴注，1次／周。结果同步放化疗组、放疗组近期有效率分别为88．6％和69．7％，差异有统计学意义（P=0．04）。同步放化疗组和放疗组的1、2、4年总生存率分别为80．0％（28／35）、57．1％（20／35）、28．6％（10／35）和63．6％（21／33）、24．2％（8／33）、12．1％（4／33），差异有统计学意义（P〈0．05）。2组远处转移率分别为45．7％（16／35）和51．5％（17／33），差异无统计学意义（P〉0．05）。同步放化疗组的Ⅲ、Ⅳ和严重药物不良反应发生率的绝对值高于放疗组，药物不良反应有增加趋势，但差异无统计学意义（P〉0．05）。结论多西他赛加顺铂方案同步放化疗能够显著提高局部晚期食管癌的近期疗效和总生存率，但药物不良反应的发生率有增加的趋势。

Objective To observe the efficacy and toxicity of concurrent chemoradiotherapy combined with docetaxel and cisplatin for local advanced esophageal carcinoma. Methods Sixty-eight local advanced esophageal carcinoma patients were randomized into two groups. The group of control（ n = 35 ） had radiotherapy only and experimental group （ n = 33 ） received chemotherapy with 40 mg/m^2 of docetaxel and 20 mg/m^2 of cisplatin one time every week plus radiotherapy（ DT 64Gy/2Gy/32Fx）. Results The overall response rates of control group and experimental group was 45.7% and 51.5% respectively, showing a significant difference （P = 0.04）. The lyear, 2year, 4year overall survival rate was 80.0%/57.1%, 28.6%/63.6%, 24.2%/12.1% respectively, also showing significant differences （P 〈 0.05 ）. The difference of distant metastasis rate and the toxicity between two groups had no statistical differences （P 〉 0.05）. Conclusion The overall survival rate of local advanced esophageal carcinoma could be improred by chemoradiotherapy.