同步放化疗治疗中晚期食管癌86例疗效分析

[目的]观察同步放化疗治疗中晚期食管癌的近期疗效和毒副作用.[方法]从2001年3月至2003年3月,将86例中晚期食管癌患者随机分为A、B两组.B组前2/3疗程常规设野放射治疗4周,后1/3疗程改为三维适形放射治疗,全疗程41～44天.A组放射治疗同B组,同时采用顺铂、5-氟尿嘧啶化疗.[结果]2、3年局控率A组分别为75.4%、60.3%,明显优于B组的68.4%、45.8%(P＜0.05),2、3年生存率在A、B两组分别为72.4%、48.5%和55.1%、35.3%,统计学有明显差异(P＜0.05).远处转移率A组为13.3%,明显低于B组的39.0%(P＜0.01).[结论]同步放化疗能提高中晚期食管癌局控率及短期生存率,降低远处转移率.长期疗效有待进一步观察.

Analysis of Effect on Concurrent Radiotherapy and Chemotherapy for 86 Cases with Advanced Esophageal Carcinoma

[Purpose]To evaluate the response and toxicity of concurrent radiotherapy and chemotherapy for advanced esophageal carcinoma. [Methods]From March 2001 to March 2003,eighty-six cases with advanced esophageal carcinoma were randomly divided into two group: Group B (41 cases) were treated with conventional fractionated radiotherapy during the first two thirds of the treatment ,then followed by late three dimensional conformal radiotherapy (3DCRT). Group A (45 cases) received the same radiotherapy schedule as Group B, with concurrent chemotherapy including cispatin and 5-fluorouracil. [Results] The 2-,3-year local control rates were 75.4% and 60.3% in Group A, and 68.4%, 45.8% in Group B respectively (P<0.05). 2-,3-year survival rates were 72.4% and 48.5% in Group A, and 55.1%, 35.3% in Group B(P<0.05). The distant metastasis rates were 13.3% in Group A which was significantly lower than that in group B (39.0%, P<0.01). [Conclusions]Concurrent radiotherapy and chemotherapy for advanced esophageal carcinoma could improve the local control and survival rates, and decrease distant metastasis rates.Further follow-up data are needed for long-term survival.