非手术食管癌同步放化疗的临床疗效

Clinical therapeutic effect of chemotherapy with concurrent radiotherapy in treatment of non-operative esophageal carcinoma

目的观察放疗联合顺铂加氟尿嘧啶(PF)化疗方案治疗非手术食管癌的临床疗效。方法 66例非手术食管癌患者随机分为2组:同步放化组(同步组)33例,序贯放化组(序贯组)33例。放疗为6MVX线三维适形,治疗剂量60 Gy,6 wk完成。化疗方案:序贯组给予顺铂30 mg.m-2.d-1,iv,d 1～3;氟尿嘧啶700 mg.m-2.d-1,iv,d 1～5,28 d为一个周期。同步组给予顺铂20 mg.m-2.d-1,iv,d 1～3;氟尿嘧啶600 mg.m-2.d-1,iv,d 1～4,28 d为一个周期与放疗同步进行。2组化疗均为4个疗程。结果同步组、序贯组近期有效率(显效+有效)分别为94%(31/33)和76%(25/33),1、3、5年生存率分别是86%、61%、30%和69%、24%、13%;2组间均有显著差异(P<0.05)。结论 PF化疗方案联合放疗同步治疗非手术食管癌可以提高近期疗效和远期生存率。

AIM To observe the clinical therapeutic effect of cisplatin（DDP）＋ fluorouracil（FU）concurrent with radiotherapy in the treatment of non-operative esophageal carcinoma.METHODS Sixty-six patients with non-operative esophageal carcinoma were randomly divided into two groups：33 patients in the concurrent chemoradiotherapy group and 33 patients in the sequential chemoradiotherapy group.All of the patients were treated with 3-dimensional conformal radiation therapy（3-DCRT）using 6MV X-ray with the total dose of 60 Gy.The chemotherapy in the sequential chemoradiotherapy group consisted of 4 cycles of DDP 30 mg·m-2·d-1（d 1-3）and FU 700 mg·m-2·d-1（d 1-5）every 28 days,and the concurrent chemoradiotherapy group consisted of 4 cycles of DDP 20 mg·m-2·d-1（d 1-3）and FU 600 mg·m-2·d-1（d 1-4）every 28 days.RESULTS The overall response rate was 94%（31/33）and 76%（25/33）in the concurrent chemoradiotherapy group and the sequential chemoradiotherapy group respectively,and the 1-,3-,5-year survival rate in the concurrent chemoradiotherapy group was 86%,61%,30% in the concurrent chemoradiotherapy group and 69%,24%,13% in the sequential chemoradiotherapy group,with significant differences between the two groups（P 0.05）.CONCLUSION DDP and FU combined with radiotherapy concurrent in the treatment of non-operative esophageal carcinoma could improve the response rate and the overall survival rate.