三维适形放疗配合TP方案同步化疗治疗食管癌临床研究

目的探讨食管癌TP方案同步放化疗的疗效。方法94例食管癌患者根据入选标准随机分组,46例进入化疗 放射治疗组(放化组),48例进入单纯放射治疗组(单放组)。放化组:化疗为TP方案,即Taxol 40mg/m2d1,DDP20mg/m2d1;放疗从第1天即开始,放疗方案为三维适形放射治疗:DT64Gy-70Gy/32-35Fr/6-7W。单放组:放射治疗方案同综合组。结果放化组的3年生存率及局控率分别为54.35%、56.52%,单放组的3年总生存率及局控率分别为33.33%、27.08%,两组显示出显著统计学差异。同步放化组远处转移率为15.21%,单放组远处转移率为31.25%。放化组的毒性反应大于单放组,但患者均能耐受。结论以TP方案化疗配合放射治疗食管癌降低了远处转移发生率,同时提高局远期生存率,虽毒性反应增加,但患者均能耐受,有进一步研究的价值。

Clinical Research of the Three Dimensional Conformal Radiation Therapy combined with TP concurrent chemoradiotherapy for Esophageal Cancer

Objective To study the clinical effect of 3D-CRT combined with TP concurrent chemoradiotherapy esophageal cancer. Methods 94 patients with inoperable esophageal cancer were divided randomly into two groups,46 patients in group A received chemoradiotherapy,while 48 patients in group B received only radiotherapy. For both groups,the same radiation technic was given with 3D-CRT. The total dose was 64-70Gy/32-35Fr/6-7W.For the group A patients were also given with concurrent chemotherapy(Taxol 40mg/m2 dl,DDP 20mg/m2 d). Results The 3-year overall survival rate and the local rate in group A was 54.35% and 56.52%,,while in group B was33.33 % and 27.08%(P < 0.05). The 3-year remote metastatic rate in group A was 15.21%,in group B was 31.25%(P< 0.05). The acute toxic effect was severer in group A than group B. Conclusion Concurrent chemoradiotherapy can reduce the remote metastatic rate,and can improve the survival rate of esophageal cancer,but can also increase the acute toxic effect.