三维适形放疗同步DF化疗方案治疗中晚期食管癌33例

[目的]探讨三维适形放射治疗（3DCRT）同步DF方案（DDP＋5-Fu）治疗中晚期食管癌的疗效及毒副反应。[方法]65例中晚期食管癌患者随机分为单放组（32例）及放化组（33例）。化疗为DF方案：氟尿嘧啶500mg/m2＋顺铂20mg/m2,d1～4,静脉滴注,21d为1个周期,共4～6个周期。3DCRT从化疗第1d开始,常规分割,DT60～66Gy,30～33次,6.0～6.6周。[结果]放化组与单放组有效率分别为91.91%、68.75%（χ2=4.99,P=0.026）。放化组1、2、3年局部控制率分别为78.24%、57.42%、42.84%,单放组分别为65.57%、46.37%、35.14%（χ2=1.855,P=0.173）。放化组1、2、3年总生存率分别为75.43%、50.42%、37.76%,单放组分别为64.42%、41.35%、31.26%（χ2=2.49,P=0.115）。毒副反应发生率放化组大于单放组,但患者均能耐受。[结论]DF化疗方案同步3DCRT治疗中晚期食管癌能够提高有效率,并有可能提高局控率及远期生存率,毒副反应增加但可耐受。

Concurrent Three Dimensional Conformal Radiotherapy and Chemotherapy with DF Regime in the Treatment for 33 Cases with Advanced Esophageal Carcinoma

[Purpose] To investigate the effect and toxicity of concurrent three dimensional conformal radiotherapy （3DCRT） and chemotherapy with DF regime （DDP＋5-Fu） for patients with advanced esophageal carcinoma. [Methods] Sixty-five patients with advanced esophageal carcinoma were randomly divided into radiochemotherapy group （n=33） and radiotherapy alone group （n=32）. DF regime： 5-Fu 500mg/m2＋DDP 20mg/m2,d1～4, 21 days as a cycle, a total of 4～6 cycles. For both groups, 3DCRT was carried out by conventional fractionation with a total dose of 60 ～66Gy/30～33fr,6.0 ～6.6w. [Results] Overall response rate in radiochemotherapy group and radiotherapy alone group was 91.91% and 68.75% respectively （χ2=4.99, P=0.026）. The 1-, 2- and 3-year local control rate was 78.24%, 57.42% and 42.84% in radiochemotherapy group, and 65.57%, 46.37% and 35.14% in radiotherapy alone group （χ2=1.855, P=0.173） respectively. The 1-, 2-and 3-year overall survive rate was 75.43%, 50.42% and 37.76% in radiochemotherapy group, and 64.42%, 41.35% and 31.26% in radiotherapy alone group （χ2=2.49, P=0.115） respectively. The acute toxicity in radiochemotherapy group was severer than that in radiotherapy alone group, but all was tolerable. [Conclusion] Concurrent 3DCRT with chemotherapy with DF regime can improve the overall response rate, and have the potential to improve the local control rate and overall survival rate. It also increases the acute toxicity but is tolerable.