食管癌放疗后复发再程三维适形放疗同步化疗的临床效果

Efficacy of concurrent treatment of three-dimensional conformal radiotherapy with chemotherapy on recurrent esophageal carcinoma after single radiotherapy

目的探讨食管癌放疗后复发再程三维适形放疗同步化疗的临床效果。方法选取许昌市中心医院2014年12月至2015年5月诊治的食管癌放疗后复发患者94例作为研究对象,按治疗方案分为对照组47例(采取单纯三维适形放疗),研究组47例(采取三维适形放疗同步化疗方案)。对两组患者的近期局部控制率、3年生存率以及死亡因素进行统计学分析。结果①研究组患者近期局部控制率为58.70%,高于对照组(54.35%),但差异未见统计学意义(P>0.05)。②研究组患者3年生存率为17.39%,高于对照组(13.04%),但差异未见统计学意义(P>0.05)。③研究组死亡38例,其中因治疗不良反应死亡占52.63%,高于对照组(27.50%),差异有统计学意义(P<0.05),而因远处转移、局部未控制死亡者占比比较差异未见统计学意义(P>0.05)。结论食管癌放疗后复发再程三维适形放疗同步化疗的临床效果稍优于单纯放疗,但对近期局部控制率和3年生存率均无较大程度改善。致死因素以不良反应为主,应在治疗中高度重视。

Objective To study the efficacy of concurrent treatment of three-dimensional conformal radiotherapy with chemotherapy on recurrent esophageal carcinoma after single radiotherapy. Methods Ninety-four esophageal patients receiving pre-rediaotherapy from December 2014 to May 2015 in Xuchang Central Hospital were divided into two groups. Forty-seven patients cases in control group received single three-dimensional conformal radiotherapy, and 47 cases in study group received concurrent treatment of three-dimensional conformal radiotherapy with chemotherapy. The recent local efficiency rate, 3-year survival rate and death cause were analyzed. Results ① The recent local control rate in observation group was 58.70%, which was higher than that (54.35%) in the control group, but there was no significant difference between the two groups (P>0.05).②The 3-year survival rate in the observation group was 17.39%, which was higher than that (13.04%) in the control group, but there was no significant difference between the two groups(P>0.05).③Thirty-eight patients died in the observation group, an 52.63% of the patients died of adverse reactions, which was higher than that (27.50%) in the control group, there was significant difference between the two groups (P<0.05). There was no significant difference in the death rate caused by distant metastasis or failure of local treatment (P>0.05). Conclusions Concurrent treatment of three-dimensional conformal radiotherapy with chemotherapy on recurrent esophageal carcinoma after single radiotherapy is a little bit better than single radiotherapy, but can't improve efficiency of local carcinoma and 3-year survival. The common death-cause is adverse reaction, which should be given high priority in treatment.