内外照射加化疗联合治疗食管癌临床分析

目的 分析外照射、腔内近距离治疗及化疗治疗食管癌的疗效及其与外照射比较。方法 １２０例食管癌随机分成４组,每组３０例。Ⅰ组为外照射,Ⅱ组为外照射加腔内照射,Ⅲ组为外照射加化疗,Ⅳ组为内照射加化疗。外照射采用＾６０Ｃｏ治疗,２Ｇｙ／次,５次／周,总剂量６０－７４Ｇｙ;腔内照射６－８Ｇｙ／次,１次／周,总量１８～２４Ｇｙ;化疗用卡铂,１００ｍｇ／ｄ,５次／周,总量１０００ｍｇ。结果 Ⅱ～Ⅳ组的１,２,３年生存率高于Ⅰ组（Ｐ〈０．０５）。Ⅰ～Ⅳ组的３年生存率分别为１３．３％、３６．７％、４０．０％和４６．７％,死于肿瘤复发及未控分别为７２．２％、４０．０％、４３．７％和３８．４％（Ｐ〈０．０５）,远处转移率无明显差异。结论 外照射与近距离治疗和化疗的综合治疗可提高食管癌局部控制率和１,２,３年生存率。

A clinical analysis of combination treatment with brachytherapy and external radiation, plus chemotherapy for the treatment of esophageal cancer

OBJECTIVE: To analyse the value of various combinations of treatment for esophageal cancer. METHODS: One hundred twenty cases of esophageal cancer were randomly divided into four groups, 30 cases in each group. Group I was treated with external radiation (RT) alone; group II, with RT plus brachytherapy; group III with RT plus chemotherapy, and group IV with RT plus brachytherapy and chemotherapy. RT with 60Co was given 2 Gy daily, 5 times a week, with a total dose of 60-74 Gy. Brachytherapy was given 6-8 Gy once weekly with a total dose of 18-24 Gy. Chemotherapy with carboplatin was given 100 mg/day, five days a week at first and fifth week. RESULTS: The 1, 2, 3-year survival rate in group II, III and IV was higher than that in group I (P < 0.05). The 3-year survival rate of group I-IV patients was 13.3%, 36.7%, 40.0%, 46.7%, respectively. More patients died of cancer recurrence and progression in group I than in any of the other 3 groups of patients (P < 0.05). However, the frequency of distant metastasis was not significantly different. CONCLUSION: The combination treatment with external radiation, brachytherapy and chemotherapy can improve the local control of tumor growth and the survival rate in esophageal cancer patients.