三维适形放疗联合不同化疗方案治疗中晚期食管癌的临床研究

目的：比较分析放疗同期多西紫杉醇、顺铂方案化疗与顺铂、5-氟尿嘧啶方案化疗的疗效及毒副反应。方法：回顾性分析2005年6月-2008年6月期间,42例放疗同期化疗的食管癌病例,临床分期Ⅱ-Ⅲ期。均为CT定位,常规分割,三维适形放疗,总剂量60-68Gy。均于放疗第1、28天联合化疗,根据同期化疗方案的不同分为两组：22例联合多西紫杉醇加顺铂方案,为TP组;20例联合顺铂加氟尿嘧啶方案,为DF组。结果：所有患者均随访至2010年12月,随访率100%。两组有效率：TP组81.8%、DF组75.0%（P〉0.05）。1、2年局部控制率：TP组86.4%、63.6%;DF组80.0%、60.0%（P〉0.05）。1、2年生存率：TP组81.8%、59.1%;DF组80%、50%（P〉0.05）。急性毒副反应,白细胞减少发生率TP组明显高于DF组;胃肠道反应发生率TP组明显低于DF组。结论：适形放疗同步多西紫杉醇、顺铂方案化疗治疗食管癌较顺铂、氟尿嘧啶方案可提高有效率、局部控制率和生存率。骨髓抑制发生率较高,但经积极治疗后可耐受,能够继续完成治疗。

Three-dimensional conformal radiotherapy combined with different chemotherapy in the treatment of advanced esophageal cancer

Objective：To compare the efficacy and toxicity between the homeochronous radiotherapy regimen with cisplatin-docetaxel and homeoehronous chemotherapy of cisplatin-fluorouracil regimen for esophageal cancer.Methods：Retrospective analysis of 42 cases of esophageal cancer treated by radiotherapy concurrent chemotherapy was performed.All cases were adopted three-dimensional conformal radiotherapy with CT location,conventional fractionation,total dose 60-68Gy.Radiotherapy combined with chemotherapy was performed at 1 and 28d.All cases were divided into two groups： 22 cases were treated combined with docetaxel plus cisplatin（group TP）;20 cases of cisplatin plus fluorouracil（group DF）.Results：All patients were followed up until（100%）.The efficiency of the two groups were： TP group 81.8%,DF group 75.0%（P0.05）.1,2-year local control rates were： TP group 86.4%,63.6%;DF group 80.0%,60.0%（P0.05）.l,2-year survival rates of the two groups were： TP group 81.8%,59.1%;DF group 80%,50%（P0.05）.Acute toxicity,of neutropenia in group TP was significantly higher than group DF;the incidence of gastrointestinal reactions in group TP was significantly lower than the group DF.Conclusion：Conformal radiotherapy simultaneous docetaxel-cisplatin chemotherapy for of esophageal cancer compared with cisplatin-fluorouracil can improve efficiency,local control and survival rates.Incidence of bone marrow suppression in the group TP was higher.