顺铂加氟脲嘧啶化疗同步放射治疗98例食管癌临床研究

目的探讨顺铂与5-FU持续120小时静脉滴注与放疗联合治疗食管癌的临床疗效、毒副反应。方法98例食管癌患者根据入选条件，随机分组，单放组33例，序贯组33例，同步组32例。放疗均为：6MV或18MVX线，先前后大野对穿照射，后适形放疗，DT62～70Gy，分31～35次，6—7周完成。化疗方案：序贯组DDP 20mg／m^2，连用5天，5-Fu 500mg／m^2，连用5天；同步组DDP＋5-Fu，DDP 15mg／m^2，连用5天，5-Fu 2．0g／m^2，持续滴注120小时，在放疗开始的第1天即行全身化疗。结果单放组、序贯组、同步组近期有效率分别为57．6％、75．8％、93．8％（X^2=11．4980，P=0．0032）。三组放射性食管炎的发生率100％，Ⅰ、Ⅱ级放射性食管炎三组差异无统计学意义；Ⅲ＋Ⅳ级放射性食管炎，序贯组和同步组比较，差异无统计学意义，二者均较单放组明显，但患者均能耐受。结论DDP＋5-FU持续120小时连续滴注化疗同步放射治疗食管癌近期疗效显著，并未明显增加近期毒副反应。

Clinical study on 98 cases esophageal cancer patients treated with chemo -radiotherapy including DDP plus 5 -Fu

Objective ： To observe the clinical therapeutic effect and side effects of three schemes treating esophageal carcinoma： radiotherapy alone, sequential chemoradiotherapy or concurrent chemoradiotherapy with DDP plus persistent vein perfuse of 5-FU for 120 hours. Methods： Ninety -eight cases of esophagus carcinoma were divided into 3 groups randomly. Thirty - three cases undertook simple radiotherapy and 33 cases sequential chemoradiotherapy, 32 cases concurrent chemoradiotherapy. DDP（20mg/m2,5 days） plus persistent vein perfuse of 5-FU （500mg/m^2, 5 days） for 120 hours chemotherapy was employed in this study. All patients received large wild irradiation and followed by conformed irradiation using 6MV or 18MV X-ray. The total dose was 62 - 70Gy accumulated with 31 - 35 times. Results ： The effective rate was 57.6% in simple radiotherapy group and 75.8% in sequential chemoradiotherapy group, 93.8% in concurrent chemoradiotherapy group. They had significant difference between the three groups（ P 〈 0. 05 ）. All patients got radiation esophagitis. There was no significant difference in the incidence rate of grade Ⅰ and grade Ⅱ radiation esophagitis （ P 〉 0. 05 ）. There was no significant difference in the incidence rate of grade Ⅲ and grade Ⅳ radiation esophagitis in sequential chemoradiotherapy group and concurrent chemoradiotherapy group（ P 〉 0. 05 ）. The incidence rate of radiation esophagitis in these two groups was higher than that in simple radiation group significantly（ P 〈0.05）. Conclusion： Concurrent chemoradiotherapy with DDP plus persistent vein perfuse of 5- FU for 120 hours has better therapeutic effect, slight toxicity and side effects in treating esophagus carcinoma.