同步放化疗治疗中晚期食管癌效果分析

目的评价3种治疗模式对中晚期食管癌的临床疗效和毒性反应。方法对解放军264医院2011年3月-2013年3月收治的采用3种治疗模式同步放化疗组（n=36）、序贯放化疗组（n=43）、单纯放疗组（n=39）]治疗的中晚期食管癌118例的临床资料进行回顾性分析。结果①近期疗效：近期有效率同步放化疗组（91．7％）、序贯放化疗组（65．1％）显著高于单纯放疗组（46．2％）（P〈0．05），同步放化疗组显著高于序贯放化疗组（P〈0．05）。②远期疗效：3组1年生存率分别为83．3％、74．4％、69．2％，差异无统计学意义（P〉0．05）；2年生存率同步放化疗组（50．0％）与序贯放化疗组（41．9％）显著高于单纯放疗组（20．5％）（P〈0．05），前两组差异无统计学意义（P〉0．05）。③毒性反应：同步放化疗组、序贯放化疗组骨髓抑制、食管炎、放射性肺炎、恶心呕吐发生率均显著高于单纯放疗组（P〈0．05），而同步放化疗组、序贯放化疗组上述毒性反应发生率差异无统计学意义（P〉0．05）。结论同步放化疗治疗中晚期食管癌效果优于序贯放化疗及单纯放疗，虽不良反应增多，但多数患者可耐受。

Effect of Concurrent Chemoradiotherapy in Treatment of Patients with Esophageal Cancer in Middle-Advanced Stage

Objective To evaluate the clinic efficiency and toxic reaction of three therapy methods in treatment of patients with esophageal cancer in middle-advanced stage. Methods Clinical data of 118 patients with esophageal cancer in middle-advanced stage, who underwent concurrent chemoradiotherapy （group A, n = 36） , sequential chemora- diotherapy （ group B, n = 43） and radiotherapy （ group C, n = 39） , during March 2011 and March 2013 in our hospital was retrospectively analyzed. Results In terms of short-term curative effects, short-term effective rate of 91.7% in group A and 65.1% in group B were significantly higher than 46.2% in group C （P 〈0. 05） , and that in group A was significantly higher than that in group B （ P 〈 0.05 ）. In terms of prostecdtive efficacy, one-year survival rates in the three groups were 83.3% , 74.4% and 69.2% respectively, and the differences were not statistically significant （P 〉 0.05 ） ; two-years of survival rate of 50.0% in group A and 41.9% in group B were significantly higher than 20.5% in group C （ P 〈 0.05）, but the difference was not statistically significant （ P 〉 0.05）. In toxic reaction, the incidence rates of my- elosuppression, esophagitis, radiation pneumonia, nausea and vomiting in group A and B were significantly higher than those in group C （ P 〈 0.05 ） , but there were no significant differences in the incidence rates between group A and B （P 〉 0.05）. Conclusion Concurrent chemoradiotherapy is more effective in treatment of patients with esophageal cancer in middle-advanced stage than those by sequential chemoradiotherapy and radiotherapy. Although it has more toxic reac- tions, most patients can tolerate it.