三维适形放疗同期PF方案化疗治疗食管癌的临床研究

Clinical research of the three dimensional conformal radiation therapy combined with PF concurrent chemoradiotherapy for esophageal cancer

目的:观察三维适形放疗同期PF方案化疗治疗食管鳞癌的近期疗效及不良反应。方法:48例符合标准的食管鳞癌,应用随机法分为同期放化疗组24例(放化组)和单纯适形放疗组24例(单放组)。放化组化疗为PF方案,即DDP40mgd1-3,5-Fu750mgd1-5;21d1周期,连续2周期。放疗从第1天即开始,放疗方案为三维适形放射治疗:DT64Gy～70Gy/32～35Fr/6～7周。单放组:放射治疗方案同放化组。结果:48例患者均完成治疗,近期疗效:单放组CR4例,PR15例,SD5例,总有效率79.16%;放化组CR9例,PR13例,SD2例,总有效率91.67%。放化组总有效率明显优于单放组(P<0.05)。结论:三维适形放疗联合PF方案化疗治疗食管癌的疗效较好,不良反应患者能耐受。

Objective To observe the short -term result and toxicity of 3- dimensional conformal radiation therapy （3 - DCRT） plus chemotherapy in the treatment of esophageal carcinoma. Method Total 48 patients with inoperable esophageal cancer were divided randomly into two groups ,24 patients in group A received hemoradiotherapy, while 24 patients in group B received only radiotherapy. For both groups ,the same radiation technic was given with 3 - DCRT. The total dose was 64 - 70Gy/32 -35Fr/6-7W. For group A patients were also given with concurrent chemotherapy （ DDP 40mg dl - 3,5 - Fu 750mg dl- 5 ）. Results The overall response of group A received chemoradiotherapy was 91.67%, with CR in 9 patients （ 37.5% ）, PR in 13 patients （54.2%）, SD in 2 patient （ 8. 3% ）. The overall response of group B received only radiotherapy was 79. 16% ,with CR in 4 patients （ 16.7% ） ,PR in 15 patients （62.5%） ,SD in 5 patients （20.8%） .The overall response of group A received chemoradiotherapy was higher than group B received only radiotherapy. Conclusion The 3 - DCRT concurrently combined with chemotherapy for patients with esophageal cancer is more effective, and the patients could tolerate the side effects.