局部晚期食管癌同步放化疗疗效观察

The clinical observation of concurrent chemoradiotherapy on locally advanced esophageal carcinoma

目的:观察局部晚期食管癌同步放化疗疗效。方法:146例局部晚期食管癌分为对照组和治疗组。74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。在模拟定位机下设定位,常规分割,即200cGy/次,5次/周,先照射4000cGy/20次,然后避脊髓放疗,总量达6400-7000cGy。72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-FU 500mg/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、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。

Objective：To evaluate the efficacy and toxicity of concurrent chemoradie therapy for locally advanced esophageal carcinoma.Methods：Total of 146 locally advanced esophageal carcinoma patients were divided randomly into two groups;control group was treated with radiotherapy only,all dose was 6400-7000cGy,the treatment group was conurrent hemoradiotherapy（5-FU 500 mg d1-5,DDP 20mg d1-5）.Treatment responses were evaluated after 2 cycles.Results：The overall response rates of the control group and treatment group was 73% and 89%,1-year,3-year,5-year overall survival the treatment group than the control group.Conclusion：The better OS of locally advanced esophageal carcinoma could be achieved with concurrent chemoradiontherapy compared with radiotherapy only while the toxicity in increasing.