三维适形放疗联合同步化疗治疗食管癌的临床观察

目的:探讨三维适形放疗联合同步化疗在食管癌治疗中的近期有效率、不良反应及生存率.方法: 128例病人根据入选标准进入研究.采用三维适形放疗,常规分割,2.0Gy/次,1次/天,5天/周,放疗剂量50-60Gy.化疗为DDP25mg/m2,静脉滴注,d1-5天,5-FU 500mg/m2,静脉滴注,d1-5,化疗在放疗第1,29天进行,共两个周期.结果: 放化疗组近期有效率为90.47%;放疗组为89.23%P>0.05.放化疗组1年及3年、5年生存率分别为63.49%、28.57%、16.67%.放疗组分别为56.92%、12.31%、1.53%(P<0.05).放化组不良反应主要是放射性食管炎及放射性肺损伤,其次是血液毒性,患者均能耐受.结论:三维适形放疗联合化疗对食管癌近期疗效及生存率较好,虽不良反应增加但病人可以耐受.

Clinical research of the three dimensional conformal radiation therapy (3D-CRT)combined with concurrent chemotherapy for esophageal cancer

Objective:To evaluate the therapeutic effetive,toxicity and survial rate of three dimensional-conformal radiotherapy(3D-CRT) combimed with chemotherapy for esophageal cancer. Methods: Total of 128 patients with esophageal cancer either inoperable or who refused operation were randomly divided into two groups:63 cases in the treatment group received 3D-CRT combined with chemotherapy DF(DDP and 5-FU),65 cases in the control group received 3DCRT alone.Radiotherapy was given with conventional fraction,the total tumor does were 50-60Gy. Results: The overall response(CR+PR) rates for the treatment group and the control group were 90.47 %,89.23%(P>0.05),respectively.The one-year survival rates for the two groups were 63.49%,56.92%.(P<0.05),respectively,the three-year survival rates for those two groups were 28.57 %,12.31 %( P<0.05),the five-year survival rates for two groups were 16.67 %,1.53 %( P<0.05) respectively.The adverse reaction manifested mainly the radiation esophagitis and radiation injury of lung,and the hematotoxicity,but they were accepted. Conclusion: Three dimensional - conformal radiotherapy combined with chemotherapy DF(DDP +5-Fu) for esophageal cancer could significantly improve the local control rate and recent effect and had slight side effect.