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目的比较食管癌单纯后程加速超分割放射治疗(LCAHR)与LCAHR联合化学治疗(LCAHR+C)的疗效。方法将78例食管鳞癌随机分成LCAHR组(单放组)和LCAHR联合顺铂(DDP)+5-氟尿嘧啶(5-Fu)化疗组(联合组)各39例。单放组前2/3疗程为常规分割,36～40Gy后改加速超分割(1.5Gy/次,2次d),照射27Gy;联合组加用DDP25mgm2、5-Fu500mgm2化疗,共3～4个周期。结果单放组及联合组的1、2、3年生存率分别为71.79%、43.59%、30.77%和87.18%、69.23%、51.28%,两组差别有显著性意义(P<0.05);1、2、3年局控率分别为71.79%、48.72%、35.90%和87.18%、71.43%、58.70%,两组差别有显著性意义(P<0.05)。联合组急性放射性反应如放射性食管、气管炎,以及血液、消化系统反应发生率均高于单放组,但患者尚能耐受。结论食管癌LCAHR联合DF方案化疗结果优于单纯LCAHR。
Objective To compare the efficacy of LCAHR and LCAHR plus chemotherapy (LCAHR + C) in esophageal cancer. Methods Totally 78 esophageal squamous cell carcinoma patients were randomly divided into LCAHR group (n = 40) and LCAHR combined with cisplatin (DDP) + 5-fluorouracil chemotherapy group (n = 39). The first 2/3 of the treatment group was routinely divided into three groups: the hyperfragments (1.5Gy / time, twice d) were changed after 36-40Gy and the irradiation was 27Gy; the combination group was treated with DDP25mgm2,5-Fu500mgm2 chemotherapy for 3 ~ 4 cycle. Results The 1, 2, 3-year survival rates of the single and combined groups were 71.79%, 43.59%, 30.77% and 87.18%, 69.23% and 51.28% respectively, with significant difference between the two groups (P <0.05); 1 . The two-year and three-year local control rates were 71.79%, 48.72%, 35.90% and 87.18%, 71.43% and 58.70%, respectively. There was significant difference between the two groups (P <0.05). Combined group of acute radioactive reactions such as radioactive esophagus, bronchitis, and blood, digestive system reactions were higher than the single release group, but patients are still able to tolerate. Conclusion The results of LCAHR combined with DF regimen in esophageal cancer are better than that of LCAHR alone.