放疗同期PF方案化疗治疗145例局部晚期食管癌临床分析

Clinical analysis of radiation therapy combined with PF regimen for esophageal cancer in 145 cases

目的回顾分析放疗同期PF方案化疗治疗145例局部晚期食管癌的临床疗效及预后因素分析。方法放疗采用60Co,每次2Gy,每周5次,总剂量60～70Gy/30～35次。放疗的同时给予PF方案化疗(顺铂20mg/d,5-FU 500mg/d,持续静脉滴注,d1～5),共2周期。结果放疗同步PF方案化疗治疗食管癌的中位生存时间为20.6月,2、3、5年总生存率分别为43.6%、32.9%和19.5%。毒副反应主要为急性骨髓抑制、放射性食管炎,以Ⅰ～Ⅱ级为主。单因素分析表明,临床分期、病变长度与食管癌治疗预后相关。结论放疗同期PF方案化疗治疗局部晚期食管癌疗效肯定,毒副反应可以耐受,值得临床推广应用。

Objective To retrospectively analyze the clinical efficacy and prognostic factors of combination ot the radiotherapy and PF regimen for 145 patients with local advanced esophageal cancer. Methods Radiotherapy was given with 60Co,with a dose fraction of 2 Gy,5 fractions per week,and a total dose of 60 -70 Gy for 30 - 35 fractions. Concurrent chemotherapy was PF regimen（cisplatin 20 mg/mz and 5-FU 500mg/d, continuous intravenous infusion, d1-5 ）,for 2 cycles. Results Median survival was 20.6 months ; 2,3 and 5 years survival rates were 43.60%, 32.9% and 19.5 %, respectively. Acute radiation esophagitis and myelosuppression were the main side effects, primarily manifested as I - Ⅱ grade. Univariate analysis results showed significant correlation of stage and disease length with overall survival. Conclusion The efficacy of combination of the radiotherapy and PF regimen for local advanced esophageal cancer is obvious, and adverse reactions can be tolerated. The therapy method is worthy to be popularized.