摘要
目的观察比较局部晚期食管癌放疗加化疗和单纯放疗的疗效。方法148例局部晚期食管癌患者随机分为两组:化放组76例,单放组72例。化疗方案:CF100～200mg,d1～5;5Fu每日500mg m2,d1～5;CDDP每日25mg m2,d1～3。化疗结束后3～7d开始放射治疗,放射治疗采用8MV X线照射,先设前后野DT40～44Gy4.0～4.4周后,即重复上述化疗方案,化疗完成后再缩野避开脊髓等中心放疗DT24～26Gy2.4～2.6周。结果化放组的1,3,5年生存率分别为73.7%、31.5%和15.8%,单放组分别为61.1%、16.7%和5.5%。两组间3,5年生存率比较差异有显著性(P<0.05)。化放组毒副反应较重。两组的死亡原因主要为局部复发,其次为远处转移,差异无显著性(P>0.05)。结论以5Fu+CDDP+CF联合诱导化疗加放射治疗局部晚期食管癌,可以提高疗效,延长生存期,虽毒副反应略增加,但患者均可耐受。
Objective To study the comparative efficacy between radiotherapy combined with chemotherapy and radiotherapy alone in treatment of patients with advanced esophageal cancer.Methods 148 patients with advanced esophageal cancer were randomized into two groups,76 patients treated with chemotherapy combined with radiotherapy(CT and RT) and 72 patients with radiotherapy alone(RT).The chemotherapy regimen included CF 100-200 mg on d1-5,5-fluorouracid 500 mg/(m^2·d) on d1-5, cisplatin 25 mg/(m^2·d) on d1-3. Three to seven days after chemotherapy,the patients were irradiated through anteroposterior(AP) and posteroanterior(PA) fields to a dose of 40-44 Gy in 4.0-4.4 weeks by 8MV X ray,and then chemotherapy was repeated again,followed by a boosting dose of 24-26 Gy in (2.4-)2.6 weeks through oblique fields. Results The 1-,3- and 5- year survival rates were 73.7%,31.5% and 15.8% in the CT and RT group and 61.1%,16.7% and 5.5% in the RT group. The differences of 3- and 5- year survival rates were statistically significant(P<0.05).The toxic and side effects of the CT and RT group were more severe than those of the RT group. The main cause of death was local recurrence and the next cause was distant metastasis in the two groups.The difference was not statistically significant (P>0.05).Conclusion The inductive chemotherapy with 5-fluorouracil,cisplatin and CF combined with radiotherapy might improve the treatment efficacy of esophageal cancer and lengthen the survival time.The toxic and side effects of the combined modality were more severe than those of radiotherapy alone ,but they were well tolerable.
出处
《中国肿瘤临床与康复》
2005年第2期140-142,共3页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
食管肿瘤/放射疗法
食管肿瘤/化学疗法
Esophageal neoplasms/radiotherapy
Esophageal neoplasms/chemotherapy
Effect
