卡铂加放射治疗食管癌的前瞻性研究

目的:探讨卡铂提高食管癌放射治疗疗效的方法。方法:180例食管癌患者根据入选标准随机分组,90例进入卡铂+放射治疗(卡放组),90例进入单纯放射治疗(单放组),卡放组放疗第1、4周同时用卡铂100mg/d,静脉滴入,每周连用5d,2个周期总量为1000mg,单放组放疗方法同卡放组。单放组60Coγ射线常规三野照射6周,共60Gy/30次。结果:近期疗效显示,卡放组完全缓解率达52.2%,单放组为36.7%,两者差异有统计学意义,P<0.05;卡放组和单放组5年生存率分别为22.2%和10%,两者差异有统计学意义,P<0.05;10年生存率分别为14.4%和6.7%,两者差异无统计学意义,P>0.05。卡放组毒副反应明显高于单放组,但患者能耐受,两组的主要死亡原因是局部复发。结论:卡铂加放射治疗食管癌可以提高疗效。毒副反应虽然有所增加,但所有患者均可耐受。

Conventional fractionation radiotherapy plus concurrent chemotherapy with CBP on esophageal carcinoma

OBJECTIVE:To evaluate the curative effect and toxicity of conventional fractionation radiotherapy (CFR) plus concurrent chemotherapy (CFR+C) with CBP on advanced esophageal carcinoma. METHODS:A total of 180 patients with advanced squamous carcinoma of esophagus were randomized into two groups (90 patients per group): Group 1. CFR group, patients were irradiated with 2.0 Gy/f , 5 times a week, to a total dose of 60 Gy; Group 2. CFR+C group, patients were given the same radiation schedual as the CFR group. On Day 1-5 and Day 22-26 of their radiotherapy courses, CBP was delivered intravenously, at the dose of 100 mg/d after irradiation. RESULTS: For the CFR and CFR+C groups, the complete response rates were 52.2% and 36.7% respectively (P<0.05), significantly improving the short treatment effects. The 5-,10-year survival rates of CFR and CFR+C were 22.2%,14.4% and 10%,6.7% respectively, P< 0.05. More acute toxicities were observed in the CFR+C group, however, they were tolerated by all the patients.CONCLUSIONS: CFR plus concurrent chemotherapy with CBP can significantly improve the short treatment effects and the survival rates of the patients with esophageal carcinoma. More acute toxicities were observed in the CFR+C, however, they could be tolerated by all the patients.