【摘要】 目的:探讨三维适形放射治疗(3-Dimensional Conformal Radiotherapy,3 DCRT)联合周剂量顺铂(DDP)与单纯3DCRT治疗局部中晚期食管癌的治疗效果及不良反应。方法:将168例局部中晚期食管癌患者随机分为两组,各84例。放化组:采用3DCRT联合每周一次DDP 25mg/m~2,静脉滴注,连续5次～6次;单放组:行单纯3DCRT治疗。结果:治疗结束后1月放化组及单放组食管片示Ⅰ级缓解率分别为57.1%及40.5%,两组差异有统计学意义(P<0.05),Ⅰ级+Ⅱ级缓解率分别为91.7%及77.4,两组差异有统计学意义(P<0.05);1年局部控制率放化组优于单放组(P<0.05),3年、5年局部控制率两组差异均无统计学意义(P>0.05);5年生存率放化组高于单放组(P<0.05);放化组及单放组死于远处转移分别为10例及25例(P<0.05);放化组及单放组死于局部未控分别为38例及37例(P>0.05);≥Ⅱ级的急性反应及后期并发症两组差异无统计学意义(P>0.05)。结论:3DCRT联合DDP治疗局部中晚期食管癌具有协同作用,具有较好的疗效,可提高肿瘤局部控制率和5年生存率,降低远处转移率。更多还原

【Abstract】 Objective:To compare the therapeutic effects and adverse reactions of 3-Dimensional Conformal Radiotherapy (3DCRT) plus weekly cisplatin with those of 3DCRT alone in locally middle-to-late stage esophageal cancer.Methods:One hundred and sixty-eight patients with locally middle-to-late stage esophageal cancer were randomly assigned into two groups.In radiochemotherapy group(84cases),3DCRT plus weekly intravenous cisplatin at the dose of 25mg/m~2 for consecutive 5-6 weeks were given to patients. In radiotherepy group(84cases),patients received 3DCRT alone.Results:Esophageal barium X-ray taken one month after treatment showed that the grade I remission rate of radiochemotherapy group and radiotherepy group was 57.1%and 40.5%respectively with significant difference(P<0.05 ).The radiochemotherapy group showed significantly higher gradeⅠ+Ⅱremission rate comparing with radiotherapy group(91.7%vs.77.4%,P<0.05).The 1-year local control rate was significantly higher in radiochemotherapy group comparing with radiotherapy group(P<0.05),but both the 3-year and 5-year local control rate showed no significant difference between these two groups(P>0.05 ).The 5-year survival rate in trial group was significantly higher than in control group(P<0.05 ).Ten paitents in radiochemotherapy group and 25 patients in radiotherapy group died of distant metastasis(P<0.05 ).Thirtyeight paitents in radiochemotherapy group and 37 patients in radiotherapy group died of failure of local control(P>0.05 ).Conclusion: 3DCRT combined with cisplatin showed synergistic effect in treating locally middle-to-late stage esophageal cancer with better effects.It can also improve local control rate and 5-years survival rate and decrease distant metastasis rate.更多还原