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目的探讨草酸铂联合氟尿嘧啶同步放化疗治疗食管癌疗效及不良反应。方法对2002年4月至2003年6月确诊为食管癌患者62例随机分成两个治疗组,试验组(31例):6MV-X射线三野等中心照射,采用常规分割,总剂量为66～70Gy/33～35次/6～7周,草酸铂130mg/m2,d1,5-Fu500mg/m2,d1～5,每21天重复,共2个周期;对照组(31例):单纯放疗,照射方式同试验组,比较两组的近期疗效及1、2年生存率和不良反应发生率。结果62例均可评价疗效。试验组:缓解率(CR+PR)%:80.6%,中位生存时间(MST)17.7月,1、2年生存率为74%(23/31)、54.8%(17/31);对照组:缓解率71.0%(22/31),MST10.2月,1、2年生存率为48%(15/31)、29%(9/31)。不良反应主要是恶心、呕吐、白细胞下降及急性放射性食管炎,神经损害:对照组0%,试验组Ⅰ～Ⅲ级25.8%,两组发生率有统计学意义(P<0.05),其余不良反应发生率两组无统计学意义。结论放射治疗配合同期草酸铂联合氟尿嘧啶方案化疗治疗有望提高食管癌放疗疗效,不良反应较少。
Objective To investigate the efficacy and adverse reactions of oxaliplatin combined with 5-fluorouracil concurrent chemoradiotherapy in the treatment of esophageal cancer. Methods Sixty-two patients with esophageal cancer diagnosed from April 2002 to June 2003 were randomly divided into two treatment groups. The experimental group (31 cases) was irradiated with 6MV-X-ray San-san et al. The total dose was 66 ~ 70Gy / 33-35 times / 6-7 weeks, oxaliplatin 130mg / m2, d1,5-Fu500mg / m2, d1-5, repeated every 21 days for a total of 2 cycles.Control group (31 cases) The way of irradiation was the same as the experimental group, and the short-term curative effect, the 1-year and 2-year survival rate and the incidence of adverse reactions were compared between the two groups. Results 62 cases can evaluate the efficacy. The survival rate of trial group was 74% (23/31) and 54.8% (17/31) respectively in the control group (CR + PR): 80.6%, median survival time : The response rate was 71.0% (22/31), MST10. The 1-year and 2-year survival rates in February were 48% (15/31) and 29% (9/31) respectively. Adverse reactions were mainly nausea, vomiting, leukopenia and acute radiation esophagitis, nerve damage: 0% in the control group, 25.8% in the test group Ⅰ ~ Ⅲ grade, the incidence of the two groups was statistically significant (P <0.05), and the remaining adverse reactions The incidence of two groups was not statistically significant. Conclusion Radiotherapy combined with oxaliplatin combined with fluorouracil chemotherapy is expected to improve the radiotherapy effect of esophageal cancer with less adverse reactions.