放化疗同时治疗食管癌

Radiotherapy plus chemotherapy simultaneously for esophageal carcinoma

目的 探讨放化疗同时治疗食管癌的价值。方法 将 6 8例食管癌患者随机分为 2组 ,一组 35例放疗同时合并 5 Fu、PDD方案化疗 (放化组 )。另一组 33例单纯放疗 (单放组 )。放疗采用 6MV或 15MV X线照射 ,中平面DT 5 5～6 5GY ;化疗共 4个周期 ,与放疗同时进行 2个周期 ,放疗结束后 2个周期。结果 随访 3年 ,放化组和单放组近期疗效CR分别为 80 %和 5 1.5 %(P <0 .0 5 )、1、2、3年生存率分别为 74.3%、5 1.4%、34.3%和 48.5 %、30 .3%、2 1.2 %。放化组生存率明显高于单放组 (P <0 .0 5 )。但骨髓抑制及胃肠道反应放化组高于单放组 (P <0 .0 5 )。结论 放化疗同时对食管癌治疗有协同作用 ,值得临床进一步探讨。

Objective To study the value of radiotherapy combined with chemotherapy for esophageal carcinoma.Methods 68 cases with esophageal carcinoma were randomized into two groups.35 cases were treated with radiotherapy combined with 5-Fu and PDD(R+C group).33 cases were used by radiotherapy alone(R group).6MV or 15MV X-ray was administrated for conventional radiotherapy with a total dose of 55～65GY;2 cycles chemotherapy were combined with radiotherapy simultaneously,another 2 cycles were used after the radiotherapy.Results All patients were followed up for 3 years.The immediate complete response(CR) of R+C group and R group was 80% and 51.5%,respectively(P<0.05).The R+C group showed higher 1-,2- and 3-year survival rates than R group,with 74.3%,51.4%,34.3% and 48.5%,30.3%,21.2% respectively(P<0.01).However a more serious side effects (bone marrow suppression and gastrointestinal irritation) occurred in R+C group(P<0.05).Conclusion Radiotherapy plus chemotherapy simultaneously for esophageal carcinoma has synergetic effect,and it needs to be further discussed.