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[目的]探讨三维适形放射治疗(3DCRT)同步DF方案(DDP+5-Fu)治疗中晚期食管癌的疗效及毒副反应。[方法]65例中晚期食管癌患者随机分为单放组(32例)及放化组(33例)。化疗为DF方案:氟尿嘧啶500mg/m2+顺铂20mg/m2,d1～4,静脉滴注,21d为1个周期,共4～6个周期。3DCRT从化疗第1d开始,常规分割,DT60～66Gy,30～33次,6.0～6.6周。[结果]放化组与单放组有效率分别为91.91%、68.75%(χ2=4.99,P=0.026)。放化组1、2、3年局部控制率分别为78.24%、57.42%、42.84%,单放组分别为65.57%、46.37%、35.14%(χ2=1.855,P=0.173)。放化组1、2、3年总生存率分别为75.43%、50.42%、37.76%,单放组分别为64.42%、41.35%、31.26%(χ2=2.49,P=0.115)。毒副反应发生率放化组大于单放组,但患者均能耐受。[结论]DF化疗方案同步3DCRT治疗中晚期食管癌能够提高有效率,并有可能提高局控率及远期生存率,毒副反应增加但可耐受。
[Objective] To investigate the efficacy and side effects of three-dimensional conformal radiotherapy (3DCRT) simultaneous DF (DDP + 5-Fu) in the treatment of advanced esophageal cancer. [Method] Sixty-five patients with advanced esophageal cancer were randomly divided into radiotherapy group (32 cases) and radiotherapy group (33 cases). Chemotherapy for the DF program: fluorouracil 500mg / m2 + cisplatin 20mg / m2, d1 ~ 4, intravenous drip, 21d for a period of 4 to 6 cycles. 3DCRT from the first day of chemotherapy, conventional segmentation, DT60 ~ 66Gy, 30 ~ 33 times, 6.0 ~ 6.6 weeks. [Results] The effective rates of radiotherapy group and radiotherapy group were 91.91% and 68.75%, respectively (χ2 = 4.99, P = 0.026). The local control rates of 1, 2 and 3 years in radiotherapy group were 78.24%, 57.42% and 42.84%, respectively, which were 65.57%, 46.37% and 35.14% respectively (χ2 = 1.855, P = 0.173). The overall survival rates at 1, 2 and 3 years were 75.43%, 50.42% and 37.76% in radiotherapy group and 64.42%, 41.35% and 31.26% in radiotherapy group (χ2 = 2.49, P = 0.115). The incidence of toxic side effects of radiotherapy group than single group, but patients can tolerate. [Conclusion] DF chemotherapy combined with 3DCRT in the treatment of advanced esophageal cancer can improve the efficiency, and may increase the rate of control and long-term survival, with increased side effects but can be tolerated.