目的观察食管癌单纯后程适形放疗(放疗组)和后程适形放疗加紫杉醇同期化疗(放化疗组)的有效率和不良反应。方法 69例食管鳞癌随机分成放疗组35例,放化疗组34例。放疗组前2/3疗程放疗用常规放疗,后1/3疗程适形放射治疗,总剂量60 Gy(30分次,5 Fx/周)。放化疗组的放疗同放疗组,化疗在放疗第1天开始,4周为1个疗程,共4个疗程。结果中位随访时间32个月,放疗组和放化疗组有效率分别为85.7%和91.2%,1、2、3年生存率分别为56.0%、34.7%、22.4%和78.1%、47.6%、33.3%;2组生存率比较差异有统计学意义(P<0.05),放化疗组Ⅲ+Ⅳ级放射性食管炎为5.9%,放疗组为2.9%(P<0.05)。放化疗组有1例患者在治疗过程中死亡。结论后程适形放疗加紫杉醇同期化疗比单纯后程适形放疗能提高局部晚期食管癌的疗效及1、2、3年生存率,但急性不良反应明显增加,最终结论需大样本的研究结果。 Objective To observe the efficacy and adverse reactions of simple posterior conformal radiotherapy (radiotherapy group) and late-course conformal radiotherapy of esophageal cancer plus paclitaxel concurrent chemotherapy (radiotherapy and chemotherapy group). Methods 69 cases of esophageal squamous cell carcinoma were randomly divided into radiotherapy group 35 cases, radiotherapy and chemotherapy group 34 cases. The first 2/3 of the radiotherapy group received conventional radiotherapy and the latter 1/3 of the conformal radiotherapy. The total dose was 60 Gy (30 times, 5 Fx / week). Radiotherapy and radiotherapy group with radiotherapy group, chemotherapy in the first day of radiotherapy, 4 weeks for a course of treatment, a total of 4 courses. Results The median follow-up time was 32 months. The effective rates of radiotherapy and radiotherapy and chemotherapy were 85.7% and 91.2%, respectively. The 1, 2 and 3-year survival rates were 56.0%, 34.7%, 22.4% and 78.1%, 47.6% 33.3%. There was significant difference in survival rate between the two groups (P <0.05). The radiotherapy and chemotherapy grade Ⅲ + Ⅳ radiation esophagitis was 5.9% and 2.9% in radiotherapy group (P <0.05). One patient in the radiotherapy and chemotherapy group died during the course of treatment. Conclusions Post-conformal radiotherapy plus paclitaxel concurrent chemotherapy can improve the efficacy of locally advanced esophageal cancer and the 1, 2 and 3-year survival rates, but the acute adverse reactions obviously increase compared with the simple late-course conformal radiotherapy. The final conclusion is that large sample study results .