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目的探讨颈、胸上段食管癌同期放化疗和单纯放疗的近远期疗效及毒副反应。方法颈、胸上段食管鳞癌患者111例随机分为放化组及单放组。两组放疗均采用适形放疗DT64.4-69.2Gy。化疗方案采用TD或PF。比较两组患者的总生存率、毒副反应、失败原因。结果放化组有效率、完全缓解率及1、3、5年生存率均高于单放组。放化组的骨髓抑制、放射性食管炎发生率较单放组为高,其他急性毒副反应、晚期副反应发生率相似。放化组局部复发率低于单放组,两组远处转移率无明显差异。结论同期放化疗可显著提高患者总生存率,降低区域失败率,但未能降低远处转移率,3-4级骨髓抑制、放射性食管炎发生率有所增加但可耐受。
Objective To investigate the short-term and long-term effects and side effects of concurrent chemoradiotherapy and radiotherapy alone on the cervical and thoracic esophageal cancer patients. Methods 111 cases of esophageal squamous cell carcinoma of neck and thoracic spine were randomly divided into radiotherapy group and radiotherapy group. Radiotherapy were used in both groups conformal radiotherapy DT64.4-69.2Gy. Chemotherapy program using TD or PF. The overall survival, toxicity and failure of the two groups were compared. The results of radiotherapy and chemotherapy group, complete remission rate, and 1, 3, 5-year survival rates were higher than the single release group. Radiotherapy group of bone marrow suppression, radiation esophagitis incidence was higher than the single group, other acute toxicity, the incidence of late side effects were similar. The local recurrence rate of radiotherapy group was lower than that of radiotherapy alone group, and the distant metastasis rate of radiotherapy group had no significant difference. Conclusions Radiotherapy and chemotherapy in the same period can significantly improve the overall survival rate and reduce the regional failure rate, but failed to reduce the distant metastasis rate, grade 3-4 myelosuppression, radiation esophagitis incidence increased but tolerated.