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目的探讨三维适形放疗联合同步化疗在中晚期食管癌治疗中的近期疗效、毒副反应和长期生存率。方法 90例不能手术或不愿手术的中晚期食管癌患者,随机分为放化疗组(45例)和单放组(45例)。放化疗组在放疗同期每周接受1次多西紫杉醇50mg,顺铂20mg静脉滴注化疗,连用3周～5周;单放组行单纯放疗。两组放疗均采用三维适形放疗。结果放化疗组近期有效率(CR+PR)为93.3%,单放组为73.3%,两组疗效无显著性差异(P>0.05)。1、2、3年生存率放化组分别为71.1%、57.8%、48.9%,单放组分别为55.6%、48.9%、17.8%,差异有显著性意义(P<0.05)。但放化组毒副反应大于单放组,不过患者均能耐受。结论三维适形放疗联合化疗治疗晚期食管癌近期疗效显著,但毒副反应略增加,值得进一步研究。
Objective To investigate the short-term curative effect, side effects and long-term survival of three-dimensional conformal radiotherapy combined with concurrent chemotherapy in the treatment of advanced esophageal cancer. Methods Ninety patients with advanced esophageal cancer who were unable or unwilling to undergo surgery were randomly divided into radiotherapy and chemotherapy group (45 cases) and radiotherapy alone group (45 cases). Radiotherapy and chemotherapy group receiving docetaxel 50mg, cisplatin 20mg intravenous infusion of chemotherapy once a week for 3 weeks to 5 weeks; radiotherapy alone group radiotherapy alone. Two groups of radiotherapy are used three-dimensional conformal radiotherapy. Results The effective rate (CR + PR) of the radiotherapy and chemotherapy group was 93.3%, while the radiotherapy and chemotherapy group was 73.3%. There was no significant difference between the two groups (P> 0.05). The 1, 2, 3 year survival rates were 71.1%, 57.8% and 48.9% in the radiotherapy group and 55.6%, 48.9% and 17.8% in the radiotherapy alone group, respectively. The difference was statistically significant (P <0.05). However, radiotherapy and chemotherapy more than side effects group, but patients can tolerate. Conclusion Three-dimensional conformal radiotherapy combined with chemotherapy for the treatment of advanced esophageal cancer has a significant effect in the near future, but the side effects are slightly increased, worthy of further study.