同步放化疗治疗可手术食管癌的临床疗效分析

目的：探讨同步放化疗及单纯放疗治疗可手术食管癌患者的近期疗效、毒副反应及远期生存率。方法210例患者随机分成两组，紫杉醇＋顺铂方案化疗同步放疗组（同步组）109例，单纯放疗（单放组）101例。同步组：紫杉醇75 mg／m2 d1，8，顺铂20 mg／m2 d1－5，每4周重复，共化疗四个周期。放疗采用常规分割，照射剂量60－66GY／32Fx；单放组：仅行放疗，方法及剂量与同步组相同。结果同步组有效率90.83％；高于单放组的66.34％；比较差异有统计学意义（ P＜0.05）。毒副反应主要为骨髓抑制、放射性食管炎、外周神经毒性等。同步组Ⅱ～Ⅳ度白细胞减少，明显高于单放组（ P＜0.05）。其他毒副反应，两组比较差异无统计学意义（ P＞0.05）；同步组1 a生存率为78.3％，高于单放组的53.7％（ P＜0.05）。结论紫杉醇＋顺铂方案同步放疗治疗可手术食管癌近期疗效及1a生存率均显著提高，毒副反应可耐受。

Clinical Efficacy of Concurrent Chemoradiation Therapy of Operable Esophageal Cancer

Objective To investigate the near-term efficacy, the toxicity and long-term survival of Operable E-sophageal Cancer for concurrent chemoradiotherapy and radiotherapy.Methods 210 cases were randomly divided into two groups, paclitaxel plus cisplatin chemotherapy concurrent radiotherapy group ( synchronous group) 109 cases, ra-diotherapy (radiation group) 101 cases.Synchronous Group:paclitaxel 75 mg/m2 d1,8, Cisplatin 20 mg/m2 d1-5, repeated every four weeks, a total of four cycles of chemotherapy.Using conventional fractionated radiotherapy, radia-tion dose 60 -66GY/32Fx; radiotherapy alone group: only radiotherapy, methods and synchronized group with the same dose.Results The efficiency was 90.83% in synchronization group ; higher than radiotherapy alone group 66.34%;the difference was statistically significant ( P<0.05).The main toxicities were myelosuppression, esophagi-tis, neurotoxicity.Synchronization groupⅡ~Ⅳdegree leukopenia was significantly higher than the radiotherapy alone group (P<0.05).Other toxicities, the two groups showed no significant difference (P>0.05);1 year survival rate of synchronous group was 78.3%, higher than radiotherapy alone group 53.7%( P<0.05).Conclusions paclitaxel+cisplatin concurrent radiotherapy treatment of operable esophageal cancer was improved significantly in efficacy and survival rate of 1 year, toxicities can be tolerated.