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目的 讨论术后同步放化疗对IIb~IIIa期食管鳞癌患者的临床疗效.方法 2009年1月至2011年12月入组IIb~IIIa局部中晚期食管鳞癌手术后患者102例,随机分为术后同步放化疗和术后单纯放疗两组.化疗方案采用顺铂75mg/m2和氟尿嘧啶1000mg/m2化疗共2个周期;两组放疗计划和方案相同,靶区定义参照RTOG8501设计,总剂量50Gy/25fx.结果 随访3年以上,随访率为100%.同步放化疗组与单纯放疗组1、2、3年总生存率分别为78.84%(42/52)、48.08%(27/52)、30.76%(19/52)和56.0%(30/50)、24.0%(14/50)、14.0%(8/50).进而生存分析显示,同步放化疗组和单纯放疗组两组患者总中位生存时间分别为25个月和14个月,两组间比较差异有统计学意义(=6.613,P=0.0130).在失败模式分析中,发现较之术后单纯放疗,术后同步放化疗能显著降低局部复发率,差异有统计学意义(=6.815,P=0.009),但是对远处转移没有影响.毒副作用可以耐受.结论 术后同步放化疗能提高IIb~IIIa期食管鳞癌患者的长期生存.“,”Objective To investigate the clinical efficacy of concurrent chemoradiotherapy for patients with esophageal squamous cell carcinoma(ESCC)from IIb to IIIa.Methods Between January 2009 and December 2011,102 patients after surgery for locally middle and advanced esophageal squamous cell carcinoma from IIb to IIIa were enrolled and randomly divided into postoperative concurrentchemoradiotherapy group and postoperative radiotherapy alone group.The chemotherapy regimen consisted of 2 cycles of cisplatin 75mg/m2 and fluorouracil 1000mg/m2.The radiotherapy plansof two groups were the same and the target area was defined according to the RTOG8501 design.The total dose was 50Gy/25fx.Results The follow-up time was>3 years and the follow-up rate was 100%.The overall survival rate of 1 year,2 years,and 3years in concurrentchemoradiotherapy group and radiotherapy alone group were separately 78.84%(42/52)、48.08%(27/52)、30.76%(19/52)and 56.0%(30/50)、24.0%(14/50)、14.0%(8/50).The further survival analysis showed that the whole median survival time of patients in concurrentchemoradiotherapy group and radiotherapy alone group were separately 25 months and 14 months,and the differencebetween the two groups was statistically significant(=6.613,P=0.0130).In the analysis of failure mode,it was found that postoperative concurrent chemoradiotherapy significantly reduced local recurrence compared with postoperative radiotherapy alone,and the differencewas statistically significant(=6.815,P=0.009).However it had no effect on distant metastasis.Toxic side effects could be tolerated.Conclusion Postoperative concurrent chemoradiotherapy can improve the long-term survival of patients with esophageal squamous cell carcinoma from IIb to IIIa.