食管癌同步放化疗与单纯放疗的疗效比较

目的：对未手术的食管癌患者进行同步放化疗,比较其与单纯放疗的疗效差异。方法选取入住我科的80例食管癌患者,随机分为研究组和对照组。研究组(40例)：三维适形放疗(3DCRT)+化疗,化疗采用顺铂(DDP)+氟尿嘧啶(5-Fu), DDP 20 mg/m2 d3-5,5-Fu 500 mg/m2 d1-5,共2个周期,分别于放疗的第1天和第28天给予；对照组(40例)：单纯3DCRT,给予单纯放射治疗。结果研究组的近期有效率为90.0%,对照组为72.5%,两组比较差异有统计学意义(P<0．05)；研究组的1、2、3年生存率高于对照组；第3年生存率明显高于对照组,差异有统计学意义(P<0．05)；除白细胞减少外,两组不良反应发生率对比结果差异无统计学意义(P>0．05)。单因素分析显示,年龄、病变长度、临床分期、贫血程度、同步放化疗对生存率有影响,多因素分析显示同步放化疗和临床分期是影响生存的独立预后因素。结论同步放化疗优于单纯放射治疗,能够提高疗效,延长患者生存期,值得临床推广应用。

Clinical research comparison of esophageal synchronous chemoradiotherapy and radiotherapy alone

Objective To evaluate the efficacy of concurrent chemoradiotherapy and radiotherapy alone in the treatment of the inop-erable esophageal cancer. Methods Eighty cases of esophageal cancer patients were selected and randomly divided into two groups, with 40 cases in each group. The treatment of concurrent radiochemotherapy group (the research group):3DCRT and DDP 20mg/m2 d3-5, d1, 28, 5-Fu 500mg/m2 d1-5, d1, 28;while that of the radiotherapy alone group(the control group):the other 40 cases were treated with 3DCRT. Results The recent effective rate was 90. 0% in the research group and 72. 5% in the control group, and the difference was statistically sig-nificant (P<0. 05). The 1, 2, 3 year survival rate of the research group was higher than that of the control group. Compared with the control group,t he difference in the third year survival rate was statistically significant (P<0. 05). Apart from leukopenia, the incidence of adverse reactions of the two group was not statistically significant (P>0. 05). The single factor analysis showed age, tumor length, clinical stage,degree of anemia, chemoradiotherapy were prognostic factors for the survival. Cox multivariate analysis showed chemoradiotherapy and clinical stage before treatment were prognostic factors for the survival. Conclusion Concurrent chemoradiotherapy is more effective than radiotherapy alone, which can effectively improve the results of treatment of patients and the three years survival situation of patients. Thus it is worth pop-ularizing in clinical application.