联合运用三维适形放疗与化疗治疗食管癌的临床疗效

目的探讨联合运用三维适形放射治疗(3D-CRT)与化疗治疗食管癌的近期疗效、局部控制率、生存率以及毒副反应。方法选择我院收治的食管癌患者80例随机分为放化组与单放组各40例。单放组行单纯3D-CRT治疗,放化组采用3D-CRT联合化疗治疗。随访3年,观察两组的近期疗效、局部控制率、生存率以及毒副反应。结果放化组与单放组完全缓解率分别为65.0%和52.5%,总有效率分别为92.5%和82.5%。放化组完全缓解率、总有效率显著高于对照组,差异有统计学意义(P<0.05)。放化组1、2、3年局控率分别为90.0%、78.0%、74.0%,单放组分别为76.0%、62.0%、50.0%。放化组1、2、3年生存率分别为80.0%、68.0%、50.0%,单放组分别为68.0%、50.0%、36.0%。放化组的局控率与生存率均显著高于单放组,差异均有统计学意义(均P<0.05)。放化组白细胞降低和放射性食管炎(Ⅲ+Ⅳ)级的发生率均大于单放组,差异均有统计学意义(均P<0.05)。结论联合运用3D-CRT与化疗治疗食管癌近期疗效和局部控制率较好,可以显著提高远期生存率,且毒副反应的增加可以耐受。

Evaluation on the efficiency of the treatment of esophageal carcinoma by three-dimensional conformal radiotherapy combined with chemotherapy

Objective To evaluate the clinical results,local control rates,survival rate and toxic side effect of the treatment of esophageal carcinoma by three-dimensional conformal radiotherapy(3D-CRT) combined with chemotherapy.Methods 80 patients with esophageal carcinoma were divided randomly into the concurrent 3D-CRT-chemotherapy group and 3D-CRT group with each group 40 cases.3D-CRT was performed only in the 3D-CRT group,while the combination of 3D-CRT and chemotherapy was performed in the concurrent 3D-CRT-chemotherapy group.The clinical results,local control rates,survival rate and toxic side effect were observed after 3 years follow-up.Results The complete response rate of both group were 65.0%and 52.5%.The total effective rate was 92.5% and 82.5%.The complete response rate and the total effective rate of the concurrent 3D-CRT-chemotherapy group were higher than those in 3D-CRT group.The differences were statistically significant(P < 0.05).The 1,2 and 3-year local control rate in the concurrent 3D-CRT-chemotherapy group was 90.0%,78.0% and 74.0% respectively,while in 3D-CRT group,they were 76.0%,62.0% and 50.0%respectively.The 1,2 and 3-year survival rate in the concurrent 3D-CRT-chemotherapy group was 80.0%,68.0% and 50.0%,while they were 68.0%,50.0% and 36.0%in 3D-CRT group.The local control rate and survival rate in the concurrent 3D-CRT-chemotherapy group were all significantly higher than those in the 3D-CRT group(all P < 0.05).The incidence of decreased WBC and(III+IV) radiation esophagitis in the concurrent 3D-CRT-chemotherapy group were all higher than those in 3D-CRT group.The differences were all statistically significant(all P < 0.05).Conclusion The combination of 3D-CRT and chemotherapy not only has good clinical results and good local control rates but also improves survival rate.In addition,the patients can tolerate the toxic side effect of this method.