顺铂联合5-FU化疗同步放疗治疗食管癌的临床效果

Clinical effect of cisplatin plus 5-FU chemotherapy combined with radiotherapy in the treatment of esophageal carcinoma

目的:探讨顺铂联合5-FU化疗同步放疗治疗食管癌的临床效果。方法:选取2010年7月-2012年6月在本院住院治疗的经组织病理学确诊的食管癌患者85例。根据放化疗方案随机分为同步放化疗组和放疗组,比较两组患者治疗后近期疗效、发生转移、局部复发率和不良反应发生率的差异。比较两组患者治疗后随访3年中位生存时间的差异。结果:同步放化疗组总的有效率(35例,87.50%)高于放疗组(31例,68.89%),差异具有统计学意义(P<0.05)。同步放化疗组患者在治疗后发生转移4例(10.0%),低于放疗组的13例(28.89%),且差异具有统计学意义(P<0.05)。同步放化疗组治疗后放射性食管炎(29例,72.50%)高于放疗组(21例,46.67%)(P<0.05)。同步放化疗组治疗后发生I级放射性肺炎7例(17.50%),放疗组发生5例(11.11%);同步放化疗组发生血液毒性26例(60.50%),放疗组发生24例(53.33%)。两组患者的放射性肺炎和血液毒性发生率的差异均无统计学意义(P>0.05)。所有患者经对症处理后均可耐受不良反应且不影响治疗进程。同步放化疗组患者的3年随访中位生存期26个月显著高于放疗组患者的19个月(log-rank P<0.001)。结论:顺铂联合5-FU化疗同步放疗治疗食管癌在不增加其不良反应的同时,明显提高了疗效。

Objective ：To investigate the clinical effect of cisplatin plus 5 - FU chemotherapy combined with radio- therapy in the treatment of esophageal carcinoma. Methods：Total of 85 esophageal carcinoma patients were divided randomly into two groups, control group was treated with radiotherapy only, the treatment group was synchronous radio- therapy and chemotherapy. To compare the differences in the short - term efficacy, the incidence of metastasis, local recurrence rate and adverse reactions between the two groups. To compare the differences of the median survival time between the two groups after treatment for 3 years. Results： The total effective rate （ 35 cases, 87.50% ） in the syn- chronous radiotherapy and chemotherapy group was higher than that in the radiotherapy group （31 cases,68.89% ）, and the difference was statistically significant （P 〈 0.05 ）. The synchronous radiotherapy and chemotherapy group of metastasis after treatment of 4 cases （ 10% ） was lower than the radiotherapy group of 13 cases （28.89%）, and the difference was statistically significant（ P 〈 0.05 ）. The incidence rate of radiation esophagitis in the synchronous radio- therapy and chemotherapy group after treatment（29 cases,72.50% ） was higher than that in radiotherapy group （21 cases,46.67% ）（P 〈0.05）. There were 7 cases（ 17.50% ） of grade I radiation pneumonia after treatment in the synchronous radiotherapy and chemotherapy group, and 5 cases （11.11%）in the radiotherapy group. 26 cases （60.50%） of hematotoxicity in the synchronous radiotherapy and chemotherapy group,24 cases（53.33% ） in the ra- diotherapy group,there was no significant difference in the incidence of radiation pneumonia and hematotoxicity be- tween the two groups （ P 〉 0.05）. All patients can tolerate adverse reactions after symptomatic treatment and do not af- fect the treatment process. The median survival of 3 years follow - up in the synchronous radiotherapy and chemother- apy group of 26 months was significantly higher than that in the radiotherapy group of 19 months （log- rank P 〈 0. 001 ）. Conclusion： Cisplatin plus 5 -FU chemotherapy combined with radiotherapy in the treatment of esophageal cancer significantly improved the efficacy and without increasing the side effects.