铂类单药化疗联合同期放疗治疗非手术食管癌的远期效果分析

目的探讨铂类单药化疗联合同期放疗治疗非手术食管癌的远期疗效。方法2008年4月至2010年2月首诊的无远处转移食管癌患者47例，化疗采用奈达铂或顺铂20mg／m2，每周1次。同期放疗采用常规分割，200cGy／次，1次／d，5d／周，放疗总量60～70Gy。结果47例患者的1、2、3、4年生存率分别为63．83％（30／47）、40．43％（19／47）、38．30％（18／47）、30．77％（4／13）。13例有淋巴结转移患者的4年生存率为0，与无淋巴结转移者的40％（4／10）相比，差异有统计学意义（x2=6．295，P=0．012）。顺铂联合同期放疗组3年生存率为31．25％（5／16），与奈达铂联合同期放疗组的41．94％（13／31）比较，差异无统计学意义（x2=0．510，P=0．475）。结论铂类单药化疗联合同期放疗治疗非手术食管癌是安全的，远期疗效有待大规模临床试验证实。

Analysis of long-term effect of platinum alone chemotherapy combined with radiotherapy for esophageal carcinoma without operation

Objective To evaluate the therapeutic effects of platinum alone chemotherapy combined with radiotherapy for esophageal carcinoma without operation. Methods Form April 2008 to February 2010, 47 initial treatment patients with esophageal carcinoma were treated by platinum alone chemotherapy （eisplatin or nedaplatin 20 mg/m2, one times per weeks） and conventional fractionated radiation therapy （200 cGy per fraction, 2 times per day, 5 days per week, to a total dose of 6 000-7 000 cGy）. Results 1-, 2-, 3-, 4-year overall survival rates were 63.83 % （30/47）, 40.43 % （19/47）, 38.30 % （18/47）, 30.77 % （4/13）. 4- year survival rate of 13 cases with lymph node metastasis was O, it was lower than that of cases without lymph node metastasis （40 %, 4/10）, the difference was statistically significant （X2 = 6.295, P = 0.012）.The 3-year survival rates in cisplatin or nedaplatin combined with radiotherapy group were 31.25 % （5/16） and 41.94 % （13/31）, the difference was not statistically significant （x2 = 0.510, P = 0.475）. Conclusion Low doses of platinum alone chemotherapy combined with radiotherapy for the treatment of esophageal cancer are safe,but long-term efficacy needs to be confirmed in larger clinical trials.