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目的 探讨联合诱导化疗提高中上段食管癌放射治疗疗效的方法。方法 16 2例食管癌患者根据入选标准随机分组 ,82例进入化疗 +放射治疗 (化放组 ) ,80例进入单纯放射治疗 (单放组 )。化疗方案 :氟尿嘧啶 5 0 0mg/m2 ·d-1,5d ;顺铂 6 0mg/m2 ,第 1天 ;平阳霉素 8mg/次 ,隔日 1次 ,3次。化疗结束后 3～ 7d开始放射治疗。放射治疗 :60 Coγ射线照射 ,先设前后 (2∶1)野DT4 0～ 4 4Gy4 .0～ 4 .4周 ,结束后成角缩野追加DT2 4～ 2 8Gy2 .4～ 2 .8周。结果 化放组的 5、10年生存率分别为2 2 .0 %、15 .9% ,单放组的 5、10年生存率分别为 13.8%、8.8% ,两组间生存率差异有显著性意义 (P =0 .0 34)。两组的毒副反应相似 ,患者均能耐受。两组的主要死亡原因是局部复发 ,但化放组死于远地转移及淋巴结转移的病例与单放组比较差异无显著性意义 (χ2 =3.4 7,P >0 .0 5 )。结论 以氟尿嘧啶、顺铂及平阳霉素联合诱导化疗加放射治疗中上段食管癌可以提高疗效。虽毒副反应有所增加 ,但所有患者均可耐受
Objective To investigate the combined induction chemotherapy to improve the upper esophageal cancer radiotherapy curative effect. Methods Twenty-two patients with esophageal cancer were randomly divided into two groups according to inclusion criteria: 82 patients undergoing chemotherapy plus radiotherapy (radiotherapy) and 80 patients undergoing radiotherapy alone (radiotherapy alone). Chemotherapy: fluorouracil 500 mg / m2 · d-1, 5d; cisplatin 60mg / m2, the first day; Pingyangmycin 8mg / times every other day, 3 times. 3 ~ 7d after the end of chemotherapy began radiotherapy. Radiotherapy: 60 Co γ-ray irradiation, the first set before and after (2: 1) wild DT4 0 ~ 4 4Gy4. 0 ~ 4 .4 weeks, after the end of the angular truncation added DT2 4 ~ 2 8Gy2 .4 ~ 2 .8 weeks. Results The 5-year and 10-year survival rates of the two groups were 22.0% and 15.9%, respectively. The 5-year and 10-year survival rates of the radiotherapy group were 13.8% and 8.8% respectively, with significant differences between the two groups Sexual significance (P = .034). Toxic side effects were similar in both groups, and the patients were well tolerated. The main cause of death in both groups was local recurrence, but there was no significant difference between the radiotherapy group and the radiotherapy group (χ2 = 3.4 7, P> 0.05). Conclusion Combined induction of chemotherapy with fluorouracil, cisplatin and pingyangmycin in the upper esophageal cancer can improve the curative effect. Although the increase in side effects, but all patients can tolerate