摘要
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 。
Objective To evaluate the effect of radiotherapy combined with inductive chemotherapy for patients with upper and middle esophageal cancer. Methods 162 patients with upper and middle esophageal cancer were randomized into two groups, with 82 treated by inductive chemotherapy combined with radiotherapy (C+R) and 80 by radiotherapy alone(R). The chemotherapy regimen included 5 fluorouracil 500?mg/m 2 on d1 d5 by continuous infusion for 120 hours, cisplatin 60?mg/m 2 on d1 and bleomycinA5 8?mg on d1,d3,d5 intravenously. Three to seven days after chemotherapy, the patients were irradiated with anteroposterior(AP) and posteroanterior(PA) fields to a dose of 40 44 Gy in 4.0 4.4 weeks followed by a boost of 24 28 Gy in 2.4 2.8 weeks through oblique fields. Results The 5 and 10 year survival rates were 22.0%, 15.9% for the C+R group and 13.8% , 8.8% for the R group. The difference was statistically significant(P=0.034). The toxic and side effects were tolerable and similar in the two groups. Nineteen patients(23%) in the C+R group and thirty one(39%) in the R group died from distant metastasis and /or lymph node metastasis, even though the difference was not statistically significant ( χ 2=3.47, P>0.05). Conclusions Inductive chemotherapy with 5 fluorouracil, cisplatin, bleomycinA5 plus radiotherapy may improve the outcome of esophageal cancer, with the toxic and side effects of the combined modality severer than radiation alone, but they are well tolerated.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2002年第1期12-14,共3页
Chinese Journal of Radiation Oncology
关键词
食管肿瘤
化学疗法
诱导化疗
放射治疗
预后
前瞻性研究
Esophageal neoplasms/chemotherapy
Inductive chemotherapy
Esophageal neoplasms /radiotherapy
Prognosis
