调强放疗同步替吉奥化疗中晚期食管癌的临床疗效观察

Clinical observation of the effect of radiotherapy combined with S-1 in advanced esophageal cancer

目的：探讨替吉奥与单药氟尿嘧啶加同步放疗治疗中晚期食管癌的近期临床疗效。方法将66例中晚期食管癌患者随机分为两组，替吉奥胶囊口服＋同步放疗组（试验组）38例，单药氟尿嘧啶静点＋同步放疗组（对照组）28例，放疗方案均采用食管病灶区适形调强放射治疗（intensity modulated radiation therapy ），放疗剂量为60∽66 Gy。观察两组临床疗效、生存情况及毒副反应。结果试验组和对照组的治疗有效率分别为894．％和893．％，差异无统计学意义（χ2＝0．012， P ＝0．996）；两组的1年、2年生存率分别为86．1％、64．1％和76．9％、419．％，差异无统计学意义；两组总的生存率比较差异无统计学意义（χ2＝07．55， P ＝0.097）；两组均无严重的放射性食管炎（3∽4级）及血液学毒副反应（Ⅳ°）的发生。结论替吉奥联合放射治疗中晚期食管癌有较好的近期疗效，且毒副反应可耐受。

Objective To evaluate the efficacy and survival rate and side reaction of S-1 combined with con-current radiotherapy in the treatment of advanced esophageal cancer .Methods 66 patients with advanced squamous cell carcinoma of the esophagus were divided into two groups ：the experimental group （38 cases） and the control group （28 cases） .The radiotherapy regimens was intensity modulated radiation therapy （IMRT） ,the radiotherapy dosage was 60 -66 Gy .Then we observed the therapeutic effect and side effect of the two groups after the treatment .Results The overall response rate （CR＋PR） of the ex-perimental group and the control group were 89 4.% and 89 3.% respectively （P 〉0.05） .The one-year and two-year survival rates of S-1 chemoradiotherapy group and Fluorouracil chemoradiotherapy group were 86 1.% ,64 1.% and 76 9.% ,41 9.% ,and the difference was not statistically significant （P 〉0.05） .Serious side effects ,including marrow depression and radioactive esophagitis ,did not occur in both groups .Con-clusion The curative effect of concurrent radiochemotherapy in locally advanced esophageal cancer is better than that of radiotherapy only ,and will not elicit the serious adverse reaction .The short term cura-tive effect of S-1 and Fluorouracil in combination with radiotherapy is feasible for medium and terminal e-sophageal cancer ,and toxicity is tolerable .