目的 :研究图像引导调强放疗联合DP方案治疗局部晚期食管癌患者近期疗效、急性不良反应和总生存率的改善。方法 :选择2012年1月~2015年9月南华大学附属第一医院放疗科收治的61例老年食管癌患者,随机分为单纯放疗组30例(单纯放疗组)和放疗同步DP方案组31例(放化疗组)。放化疗组给予DP方案同步化疗,两组均给予6MV-X图像引导下调强放疗。比较两组近期疗效、急性不良反应发生率、3年生存率。结果 :放化疗组总有效率为83.87%明显高于单纯放疗组56.7%;放化疗组局部晚期食管癌患者的3年生存率明显高于单纯放疗组;放化疗组骨髓抑制明显高于单纯放疗组;而二组患者的消化道反应和放射性食管炎差异无统计学意义,但都能顺利完成治疗。结论 :图像引导调强放疗联合DP方案化疗治疗局部晚期食管癌近期疗效确切,能明显提高患者3年生存率,且毒副反应可耐受。 Objective : To study the short-term efficacy, acute side effects and overall survival of patients with locally advanced esophageal carcinoma treated with IMRT and DP. METHODS: A total of 61 patients with esophageal cancer admitted to the radiotherapy department of the First Affiliated Hospital of Nanhua University from January 2012 to September 2015 were randomly divided into a single radiotherapy group (30 cases with radiotherapy alone) and a radiotherapy synchronous DP group (31 cases). (radiotherapy and chemotherapy group). The chemo-radiotherapy group received simultaneous chemotherapy for the DP regimen. Both groups were given 6MV-X image-guided IMRT. The short-term efficacy, acute adverse reaction rate, and 3-year survival rate were compared between the two groups. Results: The total effective rate was 83.87% in the radiochemotherapy group was significantly higher than 56.7% in the radiotherapy alone group. The 3-year survival rate of patients with locally advanced esophageal cancer in the radiochemotherapy group was significantly higher than that of the radiotherapy alone group. The bone marrow suppression in the radiochemotherapy group was significantly higher than that in the radiotherapy alone group. There was no statistically significant difference in gastrointestinal reactions and esophagitis between the two groups, but the treatment was completed successfully. Conclusion: Image-guided intensity-modulated radiotherapy combined with DP regimen chemotherapy is effective for the treatment of locally advanced esophageal cancer. It can significantly improve the 3-year survival rate of patients, and the toxicity can be tolerated.