局部中晚期食管癌同步放化疗效果探讨

目的探讨局部中晚期食管癌同步放化疗疗效。方法 59例局部中晚期食管癌分为对照组和治疗组。对照组27例行单纯放疗：照射野按病灶部位向上下各延长3～5cm,胸上段及颈段包括双锁骨上区。在模拟定位机下设野定位,常规分割,即18～20Gy/次,5次/周,先照射36～40Gy/20次,然后避脊髓放疗,总量达60～68Gy。治疗组32例：放疗同对照组,同时采用PF化疗方案,即：顺铂20 mg/d,5-FU500mg/d,静脉滴注1～5d,同时支持对症止吐等处理,28d为1周期,共化疗2周期。结果对照组近期有效率为66.6%,治疗组为87.5%。骨髓抑制方面,两组Ⅰ度、Ⅱ度、Ⅲ度、Ⅳ度发生率分别为11.5%、17.6%、13.2%、0%和34.1%、23.8%、14.8%、3.6%。1、2年生存率分别为58.6%、34.2%和79.5%、56.5%。结论同步放化疗可提高近期疗效和1、2年的生存率,但骨髓抑制有明显增加的趋势。

Clinical Observation of Concurrent Chemoradiotherapy on Locally Advanced Esophageal Carcinoma

Objective To evaluate the efficacy and toxicity of concurrent Chemo therapy with locally advanced esophageal carcinoma.Methods Totally 59 locally advanced esophageal carcinoma patients were divided randomly into two groups： the control group （27 cases） was radiotherapy only,all patients were irradiated 18 ～20 Gy/per fraction, five fractions a week, the total radiation dose was 60 ～68 Gy in tumor; the treatment group （32 cases） was concurrent chemoradio therapy （5-FU 500mg/d,d1 ～d5, DDP20mg/d,d1～d5）. Treatmentwas recycled every 28 days. Treatment responses were evaluated after 2 cycles according to WHO standard.Results The overall response rates of the control group and the treatment group was 66.6% and 87.5%, their 1-year,2-year overall survival rate was 58.6%, 34.2% and 79.5%, 56.5%. The acute toxic effect was severer in the treatment group than the control group.Conclusion The better OS of locally advanced esophageal carcinoma could be achieved with concurrent chemoradio therapy compared with radiotherapy only statistically, while the toxicity of it is increasing.