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目的:比较热放疗、放化疗和单纯放疗治疗食管癌的近期疗效、不良反应及其对患者免疫功能的影响。方法:90例食管癌患者随机分为热放疗组、放化疗组和单纯放疗组,每组30例。放射治疗均采用常规放疗方法,总剂量为60Gy。放化疗组采用同步放化疗法,化疗方案为CF(顺铂+5-氟尿嘧啶),共化疗2个周期。热放疗组于放疗后2h内接受热疗,每次1h,每周2次。结果:放化疗组有2例患者因发生严重骨髓抑制而中止治疗。热放疗组、放化疗组和单纯放疗组的近期有效率分别为76.67%、85.71%和53.33%,放化疗组与单纯放疗组的差异有统计学意义(P<0.05)。放化疗组的恶心/呕吐、白细胞减少和血小板减少不良反应发生率均高于热放疗组和单纯放疗组(P<0.05),且Ⅲ~Ⅳ度不良反应更多。热放疗组的急性放射性食管炎发生率最低(30.00%)。治疗后热放疗组的CD4+/CD8+比值较治疗前明显增加,而放化疗组治疗后CD3+、CD4+、CD8+和CD4+/CD8+水平均较治疗前有所降低;治疗后单纯放疗组的CD4+和CD4+/CD8+水平均明显低于热放疗组(P<0.05)。结论:放化疗治疗食管癌的近期疗效优于热放疗和单纯放疗,但不良反应较为严重。热放疗可增强机体的细胞免疫功能。
OBJECTIVE: To compare the short-term curative effect, side effects and immunologic function of patients with esophageal cancer treated with radiotherapy, radiotherapy and chemotherapy and radiotherapy alone. Methods: 90 patients with esophageal cancer were randomly divided into heat radiotherapy group, radiotherapy and chemotherapy group and radiotherapy group, 30 cases in each group. Radiation therapy using conventional radiotherapy methods, the total dose of 60Gy. Radiotherapy and chemotherapy group using concurrent radiotherapy and chemotherapy, chemotherapy program for CF (cisplatin + 5-fluorouracil), total chemotherapy 2 cycles. Heat radiotherapy group within 2h after radiotherapy hyperthermia, 1h, 2 times a week. Results: Two patients in radiotherapy and chemotherapy group discontinued treatment due to severe myelosuppression. The recent effective rates of radiotherapy, radiotherapy and chemotherapy and radiotherapy alone were 76.67%, 85.71% and 53.33%, respectively. There was significant difference between radiotherapy and chemotherapy group and radiotherapy alone group (P <0.05). The incidences of nausea / vomiting, leukopenia and thrombocytopenia in radiotherapy and chemotherapy group were higher than those in radiotherapy group and radiotherapy group (P <0.05), and the adverse reactions of Ⅲ ~ Ⅳ were more. The incidence of acute radiation esophagitis was lowest in the thermal radiotherapy group (30.00%). After treatment, the ratio of CD4 + / CD8 + in the radiotherapy group was significantly higher than that before treatment, while the levels of CD3 +, CD4 +, CD8 + and CD4 + / CD8 + in the radiotherapy and chemotherapy group were lower than those before treatment; CD8 + levels were significantly lower than the heat radiotherapy group (P <0.05). Conclusion: The recent curative effect of radiotherapy and chemotherapy for esophageal cancer is better than that of radiotherapy and radiotherapy, but the adverse reactions are more serious. Radiotherapy can enhance the body’s cellular immune function.