87例食管癌患者放化同步与序贯治疗的比较

目的比较T1-4N1M0期食管癌同步及序贯放化疗的疗效和不良反应。分析T1-4N1M0期食管癌放化疗后失败原因。方法自2006年2月至2009年8月,对87例区域淋巴结肿大的食管癌随机分成两组。放疗后化疗组和同期放化疗组。两级放疗均采用常规分割放射治疗,化疗均采用DF方案,同步治疗组在放射治疗第1天起给予DF方案,以后每隔28d化疗1周期,每例患者化疗不少于4周期。结果Ⅲ度以上放射性食管炎发生率,序贯治疗组为18.2%(6/33),同步放化疗组为43.7%(14/32),两组差异有显著性意义(P<0.05)。结论同步放化疗治疗T1-4N1M0期食管癌的三年生存率比序贯治疗有提高的趋势,但Ⅲ度以上放射性食管炎的发生率也有明显增高。

Comparison of 87 Cases of Esophageal Cancer Patients Radiochemical Synchronous and Sequential Treatment

Objective To compare the N1M0 T1-4 of esophageal synchronization and sequential concurrent chemoradiation efficacy and side reactions.Analysis of esophageal N1M0 T1-4 among the reason for failure.Methods From February 2006-in August 2009,87 cases of regional lymph node enlargement of esophageal into two groups at random.Radiotherapy after chemotherapy group and radiation and chemotherapy group in the same period.Two levels of radiation is using conventional segmentation radiation therapy,chemotherapy is using DF scheme,synchronous treatment group in radiotherapy for day 1 up to give DF scheme,every 28 days after chemotherapy 1 cycle,each patient not less than 4 cycles of chemotherapy.Results Ⅲ degrees above radioactive esophagitis incidence,sequential treatment group was 18.2%（6/33）,the chemoradiation group is 43.7%（14/32）,two groups of significant difference（P0.05）.Conclusion The chemoradiation therapy of esophageal T1-4 N1M0 three years of survival rate than sequential therapy improve trend,but Ⅲ degrees above the incidence of radioactive esophagitis significantly increased.