紫杉醇联合顺铂加三维适形放疗同步治疗中晚期食管癌疗效观察

目的探讨紫杉醇联合顺铂加三维适形放疗（3DCRT）同步治疗中晚期食管癌的疗效及毒副反应。方法将45例初治无远处转移的中晚期食管癌患者随机分组，22例列入3DCRT＋化疗（放化疗组），23例列入3DCRT组（单纯放疗组）。两组放疗均全程应用3DCRT，2Gy／次，1次／d，5次／w，食管癌原发病灶总剂量60～70Gy。放化疗组放疗第1天开始给予紫杉醇联合顺铂化疗，每3周为一个化疗周期，共化疗2～3个周期。结果放化疗组近期有效率（CR＋PR）为90．9％，单纯放疗组为65．2％，两组差异有统计学意义（P〈0．05）。1、2、3年生存率放化疗组分别为63．6％、50％、36．4％，单纯放疗组为47．8％、36．4％、8．6％，两组差异有统计学意义（P〈0．05）。放化疗组毒副反应大于单纯放疗组，但患者均能耐受。结论紫杉醇联合顺铂加三维适形放疗同步治疗中晚期食管癌的近期疗效确切，且可以提高远期生存率，但毒副反应增加（患者均可以耐受）。

The curative effect of PTX plus DDP combined with 3DCRT concurrently in the treatment of advanced e- sophageal carcinoma

Objective To observe the curative effect and poisonous side reaction of paclitaxel （PTX） plus DDP combined with 3DCRT concurrently in the treatment of advanced esophageal carcinoma. Methods Forty-five advanced esophageal carcinoma patients, both previously untreated and without distant metastasis were divided into two groups randomly. Twenty-two cases were in 3DCRT plus chemotherapy group （CRT）. The other 23 cases were in 3DCRT group （RT）. Both groups were applied 3DCRT during the treatment, 2 Gy/F, 1 F/d, 5 F/w, the total dose of esophageal carcinoma primary focus was 60 - 70 Gy. CRT group were given PTX plus DDP in the first day of radio- therapy, 3 weeks was one course, all together the treatment lasted for 2 or 3 courses. Results The recent response rates of CRT group were 90. 9%, that of RT group were 65.2%. There were significant differences between two groups （P 〈0.05 ）. The 1,2,3-year survival rates of the CRT group were 63.6% ,50% ,36.4%, while the survival rates of the RT group were 47.8%, 36.4%, 8.6%. There were significant differences between two groups （ P 〈 0. 05 ）. The toxic effect in CRT group are more severe than that in RT group, all the patients can tolerate it. Conclu- sion The effect of PTX plus DDP combined with 3DCRT concurrently in the treatment of advanced esophageal carci- noma is positive, and it can increase the long term survival rates. However,the toxic effect were increased （ all the patients can tolerate it）.