放疗及放、化疗结合治疗食管癌280例疗效对比分析

Contrast Anlalysis of the Curative Effect of Chemo Radiotherapy and Alone Radiotherapy in 280 Cases of Esophageal Carcinoma

目的 探讨放射治疗结合DF方案化疗对食管癌的治疗价值。方法 将 2 80例食管癌患者随机分为 2个组进行临床研究 ,一组 14 0例行放射治疗后配合DF方案化疗 (放化组 ) ,另一组 14 0例行单纯放射治疗 (单放组 )。放射治疗采用60 Coγ射线常规照射 ,DT60～ 70Gy ;化疗在放疗后 1个月内进行 ,每 3周化疗 1个周期 ,共 4～ 6个周期。 2组均随访 3年。 结果 放化组与单放组 1、2、3年生存率分别为 62 .1%、45 .0 %、3 4.2 %和 46.4%、3 2 .1%、17.8% ,放化组 1、2、3年生存率明显高于单放组 (P <0 .0 5 ) ,且无严重不良反应 ,2组局部控制率无显著性差异 (P >0 .0 5 ) ,但放化组远处转移率明显低于单放组 (P <0 .0 1)。结论 放射治疗后配合DF方案化疗对食管癌患者疗效较好 。

Objective To study the effect of chemotherapy with DF regimen after radiotherapy for esophageal carcinoma.Methods From 1992 to 1995,a prospecitve randomized trial was carried out 280 patients were rantdomized into combined group(R+C,140 patients) or radiotherapy alone group(R,140 patients),cobalt was used for all patients,with 3 fields to deliver 60～70 Gy.Chemotherapy was given every 3 weeks for 4～6 cycles after radiotherapy in R+C group.Both groups were followed for 3 years.Results The one,two and three year survial rates were 62.1%,45.0%,34.2% in R+C group and 46.4%,32.1%,17.8% in R group,respectively.The survival rates in R+C group were much better than those in R group( P <0.05).The local control rate was 30.0%(42/140) in R+C group and 37.1%(52/140) in R group( P >0.05).But there was significant difference in distant metastasis between two groups R+C group was much lower than R group( P <0.01).Conclusion Chemotherapy with DF regimen after radiotherapy has good effect for esophageal carcinoma.