同步放化疗联合与单纯化疗对中晚期食管癌疗效观察

目的探讨同步放化疗与单纯化疗对中晚期食管癌生存期和疾病进展时间的影响及其近期疗效与毒性反应。方法88例食管癌患者根据入选标准随机分组，43例行放疗＋化疗（放化组），45例行单纯化疗（单化组）。化疗应用紫杉醇175mg／m^2，静脉点滴，每日一次；DDP75mg／m^2静脉点滴，每日一次；21d为1个周期。放疗从第一天开始，6MVX线或^60Coγ线三野等中心照射，DT60～65Cy，30～33分次，6．0—6．5周。结果放化组与单化组完全缓解率分别为32．6％、13％（P〈0．05）。1年、2年、3年局部控制率，放化组分别为79％、65％、51％，单化组的分别是69％、49％、42％（P=0．056）。1年、2年、3年生存率，放化组分别是77％、58％、47％，单化组的分别是67％、42％、38％（x^2=2．27，P=0．132）。放化组毒性反应大于单化组，化疗最常见的不良反应主要为轻度骨髓抑制和乏力，但患者均能耐受。结论紫杉醇联合DDP化疗同步放疗可提高中晚期食管癌患者的近期疗效和局部控制率，延长患者生存时间，患者毒性反应能耐受。

Prospective effect of concurrent chemotherapy combined with radiotherapy versus chemotherapy alone in patients with middle - metastatic or relapsed esophageal cancer.

Objective To investigate the influence on the time of progression and overall survival in patients with middle - metastatic or relapsed esophageal squamous cell carcinoma of chemotherapy combined with radiotherapy versus chemotherapy alone, and to evaluate the efficacy and toxicity of the regimen. Methods Eighty - eight patients with inoperable esophageal cancer were divided randomly into two groups ,43 patients in group R ＋ C received chemoradiotherapy, while 45 patients in group R received radiotherapy only. Chemotherapy apply with paclitaxel 175 mg/m^2 on dl and cisplatin 75 mg/m^2 on dl ,which were repeated every 21 days. In both groups, the same radiation technic was carried out by conventional fraetionation, to a total dose of 60- 65 Gy/30- 33Fr/6.0 -6.5W. Results Complete response rate in group R ＋ C was 32. 6%, while in group R, it was 13% （ P 〈 0.05 ）. The 1 - year, 2 - year, and 3 - year local control rates in group R ＋ C were 79% ,65% ,and 51% ,while in group R,they were 69% ,49% and 42% respectively;The 1 -year,2 -year, and 3 - year survive rates in group R ＋ C were 77% ,58% and 47% ,while in group R,they were 67% ,42% and 38% （X^2 = 2.27 ,P = 0. 132 ） respectively. The acute toxic effect was severer in group R ＋ C than in group R. Systemic adverse effects frequently occurred during radiotherapy were esophagitis and fatique, which were tolerable. Conclusion The combined therapy using chemotherapy （ paclitaxel ＋ eisplatin ） can improve the complete response rate and partly eonetrol rate in patients with middle - metastatic or relapsed esophageal squamous cell carcinoma , also have the potential of improving the survival time of the patients, but it can also increase the acute toxic effect.