同步放化疗治疗高龄食管癌45例的临床分析

目的：高龄晚期食管癌同步放化疗的疗效，毒副反应及耐受性观察。方法：45例失去手术机会的老年食管癌分为两组。放化疗组22例，单放疗组23例。结果：放化疗组有效率为86.4％，对照组有效率为56．5％，统计学处理有差异（P〈0．05）主要毒副反应为胃肠道反应，食管炎，骨髓抑制等，程度多为Ⅰ-Ⅱ度，大部分病人可以耐受。结论：同步放化疗治疗高龄晚期食管癌的疗效较单纯放疗疗效好，老年患者可以耐受。     

术前同步放化疗联合手术治疗局部晚期食管癌的疗效评价

目的探讨术前同步放化疗联合手术治疗局部晚期食管癌的临床疗效。方法选取2008年1月至2011年12月局部晚期食管癌患者68例,研究组38例患者给予多西他赛75 mg/m2,第1天静滴,顺铂30 mg/m2,第1~3天静滴,21天为1周期,并行同步三维适形放疗,化疗结束后2周手术。对照组患者30例直接手术。结果全组病例无手术死亡,术后并发症发生率差异无统计学意义(均P>0.05)。研究组患者完全性切除率为94.7%(36/38),对照组完全性切除率73.3%(22/30),两组差异具有统计学意义(P<0.05)。研究组和对照组1、2、3年生存率分别为89.5%、55.3%、42.1%和66.7%、30.0%、16.7%,研究组1、2、3年生存率均显著高于对照组,差异具有统计学意义(均P<0.05)。结论局部晚期食管癌术前应用多西他赛和顺铂同步放化疗可降低食管癌临床分期,提高完全性切除率,并可提高术后1、2、3年生存率。     

中晚期食管癌98例同步放化疗的疗效观察

目的探讨同期放化疗对中晚期食管癌的疗效。方法 98例食管癌中43例行单纯放射治疗（单放组）,以6 MVX常规照射,2 Gy/次,5次/周,照射总剂量为50 Gy,另55例行化放疗联合治疗（化放组）,予顺铂（DDP）联合氟尿嘧啶（5-Fu）（DDP 20 mg/m2,d1～d5;5-Fu 500 mg/m2,d1～d5）,28天为1个周期,放疗方案同单放组,观察两组的近期疗效、远期疗效和不良反应。结果化放组有效率（RR）为65.4%,高于单放组（44.1%）（P〈0.05）。KPS评分化放组较单放组显著提高（P〈0.05）,化放组3年生存率为11.9%,高于单放组（6.9%）（P〈0.05）。两组主要不良反应包括白细胞减少、消化道反应和放射性食管炎,化放组白细胞减少发生率高于单放组（P〈0.05）。结论对中晚期食管癌患者,同期放化疗较单纯放疗的近期疗效更好,可明显改善患者的生存质量,延长患者生存时间,且相对安全。     

同步放化疗治疗中晚期食管癌的疗效观察

目的 观察放疗联合DF方案同步化疗治疗中晚期食管癌的疗效.方法 放疗联合DF方案(DDP+5-Fu)同步化疗综合治疗中晚期食管癌80例,单纯放射治疗中晚期食管癌76例.结果 放化组和单放组的近期疗效总有效率分别为76.3%和59.2%,1、2、3年生存率分别为70.0%、51.3%、38.8%和51.3%、32.9%、23.7%,放化组明显优于单放组(P<0.05).同期放化组的毒副反应高于单放组,经对症处理后患者能耐受,不影响治疗的进行.结论 同期放化疗优于单纯放射治疗,可明显提高中晚期食管癌的疗效.     

60例中晚期食管癌的放化疗疗效观察

为探讨放疗联合化疗治疗中晚期食管癌的临床治疗价值,我们收集了新疆医科大学第一附属医院2002年1月至2006年12月手术的中晚期食管癌患者60例,进行回顾性分析,结果如下.     

奈达铂和氟尿嘧啶同步放化疗治疗食管癌疗效分析

目的探讨常规剂量奈达铂(NDP)加氟尿嘧啶(5-Fu)同步放化疗治疗中晚期食管癌的疗效和毒性。方法2003年10月-2004年8月收治79例失去手术指征的食管癌,随机分为NDP和5-Fu同步放化疗治疗食管癌40例(治疗组)和单纯放射治疗食管癌39例(对照组)。全部患者采用常规放疗,总剂最为66Gy,2Gy/次,5次/周。在放疗同时,治疗组给NDP20mg静滴d1-5,5-Fu750mg静滴d1-5,每28天一周期,共用4周期。结果按WHO实体瘤疗效评价标准评定近期疗效和毒副反应评定标准评定毒副反应。治疗组完全缓解15例,部分缓解19例,总有效率85.00%;对照组完全缓解9例,部分缓解16例;总有效率64.10%。二者比较差异有显著性(P<0.05,χ2=4.56)。1年和2年生存率治疗组和对照组分别是84.96%,54.28%和67.84%,28.74%。二者生存曲线比较有统计学差异(P<0.05,χ2=5.11),毒副反应二者比较差异无显著性。结论常规剂量NDP和5-Fu同步放化疗治疗中晚期食管癌疗效确切毒副作用可以耐受。     

同步放化疗与序贯放化疗治疗中晚期食管癌的临床研究

目的 比较同步放化疗与序贯放化疗治疗中晚期食管癌的近期疗效和长期生存率.方法 168例中晚期食管癌患者随机分为两组:同步放化疗组91例;序贯放化疗组77例.同步放化疗组:放疗2 Gy/次,总量50～ 56 Gy.同步化疗2周期,放疗结束后继续化疗4周期;序贯放化疗组:放疗2 Gy/次,总量60 ～64 Gy.待放疗结...     

局部晚期食管癌同步放化疗疗效观察

目的:观察局部晚期食管癌同步放化疗疗效.方法: 146例局部晚期食管癌分为对照组和治疗组.74例对照组行单纯放疗:照射野按病灶部位向上下各延长3-5cm,胸上段及颈段包括双锁骨上区.在模拟定位机下设定位,常规分割,即200cGy/次,5次/周,先照射4000cGy/20次,然后避脊髓放疗,总量达6400-7000cGy.72例治疗组:放疗同对照组,同时采用PF化疗方案,即顺铂20mg/d,5-FU 500mg/d,静脉滴注1-5d,同时支持对症止吐等处理, 28d为1周期,共化疗2周期.结果: 对照组近期有效率为73%,治疗组为89%.骨髓抑制方面,两组Ⅰ度、Ⅱ度、Ⅲ度、度发生率分别为13.5%、18.9%、16.2%、0%和36.1%、27.8%、16.7%、2.7%.1、2、3年生存率分别为59.5%、35.1%、16.2%和80.5%、55.5%、19.4%.结论: 同步放化疗可提高近期疗效和1、2年的生存率.     

食管癌放疗与同步放化疗的疗效分析

食管癌确诊时，只有20％可行根治性切除，其余80％主要依靠放疗和其他学科的综合治疗。但食管癌单纯放射治疗的生存率不高，失败的主要原因是局部未控，其次是远处转移，综合治疗有望提高疗效。我科于2001年3月至2002年7月对90例初治食管癌患者进行同步放化疗和单纯放射治疗的随机对照研究，现报告如下。     

非手术食管癌同步放化疗研究进展

0引言食管癌是一种常见恶性肿瘤,我国食管癌的发病和死亡平均水平列恶性肿瘤前列[1]。就诊时大多数患者已是临床中晚期,自然病程仅6~8月[2]。在欧美同步放化疗已成为食管癌的标准治疗模式。它包括术前同步放化疗、术后同步放化疗及非手术同步放化疗。本文综述非手术食管癌同步放化疗近年的研究进展。     

同步放化疗治疗不能手术的食管癌临床结果

目的 探讨同步放化疗治疗不能手术的食管癌的近期疗效、生存期及毒性反应.方法 88例食管癌患者根据入选标准随机分组,43例进入放疗＋化疗组（放化组）,45例进入单纯放疗组（单放组）.化疗为第1～4天氟尿嘧啶500mg/m^2＋顺铂20mg/m^2（DF方案）.放疗从第1天即开始,6MVX线三野等中心照射,DT60～65Gy,30～33分次,6.0～6.5周.结果放化组与单放组完全缓解率分别为32.6%、13%（X^2=4.63,P＜0.05）.1、2、3年局部控制率放化组分别为79%、65%、51%,单放组的分别为69%、49%、42%（X^2=3.12,P=0.056）.1、2、3年生存率放化组分别为77%、58%、47%,单放组的分别为67%、42%、38%（X^2=2.27,P=0.132）.放化组毒性反应大于单放组,但患者均能耐受.结论 以DF方案化疗配合放疗不能手术的食管癌近期疗效和局部控制率较好,有提高远期生存率可能,虽毒性反应增加但能耐受.     

同期放化疗对侵犯气管的局部晚期食管癌的疗效观察

目的　探讨同期放化疗对晚期食管癌侵及气管的临床疗效。方法　收集经病理检查确诊的１６８例食管癌侵及气管病例,其中７３例采取单纯放射治疗（单放组）,以６／１５ＭＶＸ线常规外照射,１.８Ｇｙ／次,５次／周,照射总剂量６１.２～６４.８Ｇｙ;９５例患者行化放疗治疗（化放组）,予顺铂（ＤＤＰ）联合氟尿嘧啶（５-ＦＵ）方案化疗（ＤＤＰ２０ｍｇｄ１～ｄ５,５-ＦＵ５００ｍｇ／ｍ２ｄ１～ｄ５）４个周期,２８天为１周期,于第２周期化疗开始时行同期放疗,放疗方案同单放组。观察两组的近期疗效、毒副反应和远期疗效。结果　化放组的有效率（ＲＲ）为６５.３％,高于单放组的４５.２％（Ｐ＝０.００９）;化放组较单放组ＫＰＳ评分提高更显著（Ｐ＝０.００４）。化放组的３年生存率为１７.９％,高于单放组的６.９％（Ｐ＝０.０３５）。两组主要毒副反应包括急性放射性食管炎、放射性气管炎和白细胞减少,化放组的白细胞减少发生率高于单放组（Ｐ＝０.０２２）。结论　同期放化疗对晚期食管癌侵及气管患者较单纯放射治疗的近期疗效好,明显改善患者的生活质量,生存时间延长,且相对安全。     

食管癌放化疗研究进展

国外对食管癌同时放化疗已有了肯定的临床结果。为了更好地提高疗效,人们更多地在研究术前同时放化疗后加手术的治疗方法,有些研究应用加速超分割放疗联合化疗治疗食管癌也获得了初步结果。     

Reduction in cardiac volume during chemoradiotherapy for patients with esophageal cancer

We investigated the change in cardiac volume over the course of chemoradiotherapy in 26 patients treated for esophageal cancer, using cone beam CT imaging. The cardiac volume reduced significantly, with a median reduction of 8%. A significant relationship with planned cardiac dose was not found.     

紫杉醇周疗同步放疗治疗复发转移乳腺癌

目的 探讨伴有压迫症状的脑转移或骨转移且合并内脏转移的晚期乳腺癌合理的治疗模式。方法 化疗方案均为单药紫杉醇80 mg/m² d1,d8、d15,21天为1周期。全脑放疗采用高能X线全脑对穿照射,总量分别为45 Gy和40 Gy。骨放疗采用X线外照射,总量分别为33 Gy和40 Gy。放化疗同步进行。临床疗效评定按WHO实体瘤疗效评定标准。每完成2个周期化疗进行一次疗效评价。结果 4例患者总体疗效评价均为PR,神经系统压迫症状及骨痛症状均得到缓解,TTP分别为9个月、5个月、6⁺个月和8.5个月。结论 采用同步放化疗治疗有压迫症状的脑转移或骨转移且合并内脏转移的晚期乳腺癌,可以有效缓解症状、改善生存质量。     

Esophagectomy after concurrent chemoradiotherapy improves locoregional control in clinical stage II or III esophageal cancer patients

PURPOSE: To evaluate the effect of surgical resection on the outcome of patients with clinical Stage II or III cancer of the esophagus treated with concurrent chemoradiotherapy. METHODS AND MATERIALS: A retrospective review of 132 consecutive patients with clinical Stage II or III esophageal cancer treated with concurrent chemoradiotherapy between January 1990 and December 1998 was performed. Of the 132 patients, 60 underwent esophagectomy 6-8 weeks after chemoradiotherapy. The median radiation dose was 50 Gy (range, 30-64.8 Gy) in the definitive chemoradiation group and 45 Gy (range, 30-50.4 Gy) in the chemoradiation plus esophagectomy group. RESULTS: Statistically significant differences were found between the two groups in median age, histologic subtype, tumor location, and number of patients with T4 disease. Patients who underwent definitive chemoradiotherapy were older (p = 0.0004) and more likely to have squamous cell carcinoma than adenocarcinoma (p <0.000), upper thoracic or cervical esophageal tumors (p <0.000), and T4 tumors (p = 0.024). Patients treated with chemoradiation plus esophagectomy had statistically significant superior 5-year loco-regional control (67.1% vs. 22.1%, p <0.000), disease-free survival (40.7% vs. 9.9%, p < 0.000), and 5-year overall survival (52.6% vs. 6.5%, p < 0.000) rates and median survival time (62 vs. 12 months) compared with patients treated with chemoradiotherapy only. However, no statistically significant difference was found in the rate of distant metastasis-free survival between the two groups (67.5% vs. 65.8%, p = 0.3). Surgical resection of the tumor was an independent predictor of improved locoregional control and overall survival in both univariate and multivariate analyses. To reduce the effect of the selection bias on the outcome, 34 patients in each group with matched pretreatment characteristics were compared. The results showed statistically significant better overall survival, disease-free survival, and locoregional control in favor of the chemoradiotherapy plus esophagectomy group. No statistically significant difference in distant metastasis-free survival was found in this subgroup analysis. CONCLUSIONS: Locoregional control was better in clinical Stage II or III esophageal cancer patients treated with concurrent chemoradiation plus esophagectomy. An improvement in survival occurred in the chemoradiation plus esophagectomy group, although this observation may have reflected selection bias. The results from this study suggest the need for a randomized trial to compare chemoradiation with or without esophagectomy in the treatment of cancer of the esophagus.     

Multi-institutional analysis of cervical esophageal carcinoma patients treated with definitive chemoradiotherapy: TROD 01-005 study

The aim of this study was to examine the prognostic factors and treatment outcomes of cervical esophageal carcinoma (CEC) patients who underwent definitive chemoradiotherapy (CRT). The clinical data of 175 biopsy-confirmed CEC patients treated with definitive CRT between April 2005 and September 2021 were retrospectively analyzed. The prognostic factors predicting overall survival (OS), progression-free survival (PFS), and local recurrence-free survival (LRFS) were assessed in uni- and multivariable analyses. The median age of the entire cohort was 56 years (range: 26–87 years). All patients received definitive radiotherapy with a median total dose of 60 Gy, and 52% of the patients received cisplatin-based concurrent chemotherapy. The 2-year OS, PFS, and LRFS rates were 58.8%, 46.9%, and 52.4%, respectively, with a median follow-up duration of 41.6 months. Patients’ performance status, clinical nodal stage, tumor size, and treatment response were significant prognostic factors for OS, PFS, and LRFS in univariate analysis. Non-complete treatment response was an independent predictor for poor OS (HR = 4.41, 95% CI, 2.78–7.00, p < 0.001) and PFS (HR = 4.28, 95% CI, 2.79–6.58, p < 0.001), whereas poor performance score was a predictor for worse LRFS (HR = 1.83, 95% CI, 1.12–2.98, p = 0.02) in multivariable analysis. Fifty-two patients (29.7%) experienced grade II or higher toxicity. In this multicenter study, we demonstrated that definitive CRT is a safe and effective treatment for patients with CEC. Higher radiation doses were found to have no effect on treatment outcomes, but a better response to treatment and a better patient performance status did.     

90例不同部位食管癌同步放化疗后疗效分析

目的 探讨颈胸上段食管癌和胸中下段食管癌同步放化疗疗效及食管狭窄情况.方法 选取2011年1月至2014年12月在江苏省苏北人民医院诊治的不同部位食管癌初治患者90例,均行同步放化疗,放疗中位剂量60 Gy,化疗方案为紫杉醇联合奈达铂方案.其中,颈胸上段食管癌48例,胸中下段食管癌42例,比较两组近期有效率、局部控制率、生存率及食管狭窄情况.结果 随访率为100％,颈胸上段食管癌组和胸中下段食管癌组近期有效率分别为81.2％、73.8％(x2=0.717,P=0.397);1年局部控制率分别为90.3％、71.8％(x2=5.865,P=0.015);1年生存率分别为87.5％、69.0％(x2=4.580,P=0.032);中度及以上程度食管狭窄发生率分别为55.6％、29.4％(x2 =5.360,P=0.021).两组在近期疗效方面差异无统计学意义,而颈胸上段食管癌组在1年局部控制率、1年生存率和食管狭窄发生率上均明显高于胸中下段食管癌组,差异有统计学意义.结论 颈胸上段食管癌疗效较胸中下段食管癌好,但颈胸上段食管癌放疗后食管狭窄程度较胸中下段食管癌重.