同步放化疗与单纯放疗颈、胸上段食管癌临床研究

目的探讨颈、胸上段食管癌同期放化疗和单纯放疗的近远期疗效及毒副反应。方法颈、胸上段食管鳞癌患者111例随机分为放化组及单放组。两组放疗均采用适形放疗DT64.4-69.2Gy。化疗方案采用TD或PF。比较两组患者的总生存率、毒副反应、失败原因。结果放化组有效率、完全缓解率及1、3、5年生存率均高于单放组。放化组的骨髓抑制、放射性食管炎发生率较单放组为高,其他急性毒副反应、晚期副反应发生率相似。放化组局部复发率低于单放组,两组远处转移率无明显差异。结论同期放化疗可显著提高患者总生存率,降低区域失败率,但未能降低远处转移率,3-4级骨髓抑制、放射性食管炎发生率有所增加但可耐受。

Concurrent three dimension conformal radiotherapy and chemotherapy followed by consolidation chemotherapy for Esophageal carcinoma

Objective To investigate the comprehensive treatment of Esophageal carcinoma,and to compare the efficacy and toxicity of concurrent chemoradiotherapy.Methods One hundred and eleven patients with esopheageal cancer were randomly divided into two groups： Group A： 59 patients were given concurrent CDDP plus 5-FU or CDDP plus TOXITACEL and radiotherapy（CRT）.Group B： 52 patients were treated by radiotherapy alone（RT）.Results In Group B,the complete response rate,partial response rate,overall response rate,and the 1-,3-,5-year survival rates were better than Group A.Concurrent chemoradiotherapy can increase the overall response rate,reduce the local aborted rate,and it is safe and effective The difference between group A and B was statistically significant.Conclusions The 3-4 grade radiation pneumonitis and radiation esophagitis in Group A was higher than Group B,but it is tolerable.Concurrent chemoradiotherapy can increase the overall response rate,reduce the local aborted rate,and it is safe and effective to esophageal carcinoma patients either inoperable or who refused operation.