同步化放疗治疗食管癌的临床研究

Concurrent chemoradiotherapy for locoregional esophageal cancer

目的 评价同步化放疗治疗食管癌的疗效及毒副反应。方法 自 1995年 6月至 1997年 8月 ,32例食管癌患者 (Ⅱ～Ⅲ期 )接受同步化放疗。放疗 :每次 2GY ,每天 1次 ,每周 5次 ,总量 6 0GY。化疗 ,5 氟脲嘧啶 30 0mg/m2 ,静滴 ,第 1～ 5天 ;顺铂 10mg/m2 ,静滴 ,第 1～ 5天 ,在放疗的第 1、4周用药 ,放疗结束后 3周增加一周期化疗 :5 氟嘧啶 5 0 0mg/m2 ,静滴 ,第 1～ 5天 ;顺铂 2 0mg/m2 静滴 ,第 1～ 5天。结果 12例CR ,13例PR ,2例SD ,5例PD ,中位生存期 18个月 ,1、2、3年生存率分别为 72 %、41%、31%;1、2、3年无病生存率分别为 2 8%、2 2 %、16 %。到目前为至 ,2 2例患者死亡 ,13例因局部复发 ( 4 1%) ,7例 ( 2 2 %)因远处转移 ,2例 ( 6 %)局部复发伴远处转移。最常见的副作用为食管炎 10 0 %,其中Ⅲ～Ⅳ度占 2 2 %;白细胞下降 10 0 %,其中Ⅲ～Ⅳ度占 31%,全组无治疗相关性死亡。结论 同步化放疗疗效肯定 ,患者可以耐受。

Objective To investigate the efficacy and toxicity of concurrent chemoradiotherapy (CCRT) for locoregional carcinoma of esophagus.Methods Between June 1995 and August 1997,32 patients with locoregional carcinoma of esophagus were treated with CCRT.Radiation therapy(RT) was administered in daily 2GY fraction,5 days a week,till a total dose of 60GY,concurrently with 5-fluorouracil(5-Fu)(300mg/m 2,days 1～5) and cisplatin(CDDP)(10mg/m 2,days 1～5),both being given during weeks 1 and 4 of the RT course,one additional course of 5-FU (500mg/m 2,days 1～5),CDDP (20mg/m 2,days 1～5) given 3 weeks following completion of the RT.Results Of 32 patients,there were 12 CR,13 PR,2 SD,5 PD with a median survival time of 18 months.The 1-,2- and 3- year survival rates were 72%,41%,31%,respectively,and the 1-,2- and 3-year disease-free survial rates were 31%,22%,16%.Up to now,there were 22 deaths, of whom 13(41%) patients died of locoregional recurrence,7(22%) of distant metastasis and (6%) of both locoregional recurrence and distant metastasis.The most frequent toxicities were esophagitis and leukopenia,and there were no treatment-related deaths.Conclusion CCRT is an effective and safe treatment for locoregional advanced esophageal carcinoma.