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目的 分析体外放射联合腔内放疗加同期化疗治疗局部晚期食管癌的疗效。方法 1995年 12月至 1997年 12月 ,88例局部晚期食管癌随机分为两组 :44例用60 Co γ射线或 6MV X射线外放射DT=5 5 2 0～ 6 0 0 0CG/4 6～ 5 0次 /2 3～ 2 5天 ;平均 3天后用192 Ir源HDR腔内放疗DT=5 0 0～ 10 0 0CGY/2～ 4次。DF方案化疗于放疗前一周开始 ,共化疗两周期 (综合组 ) ;对照组 44例单用放疗。结果 综合组 1、2、3年生存率分别为 79.2 %、33 .4%、15 .6 % ,对照组 77.3 %、36 .4%、12 .5 %。两组局部未控、复发和转移率相似 (P >0 .0 5 ) ,非癌死亡率综合组明显高于对照组 (P <0 .0 5 )。结论 体外放射联合腔内放疗加同期化疗不能进一步提高局部晚期食管癌 3年生存率。
Objective To analyze the curative effect of extracorporeal radiation combined with intracavitary radiotherapy plus concurrent chemotherapy in the treatment of locally advanced esophageal cancer. Methods From December 1995 to December 1997, 88 patients with locally advanced esophageal cancer were randomly divided into two groups: 44 patients with 60 Co γ-rays or 6 MV X-ray external radiations DT = 5200-600 0CG / 46 ~ 5 0 times / 2 3 ~ 2 5 days. After an average of 3 days, 192 Ir source HDR was used to treat DT = 5000 ~ 10 0CGY / 2 ~ 4 times. DF regimen chemotherapy in the week before radiotherapy, two cycles of chemotherapy (comprehensive group); control group of 44 patients with radiotherapy alone. Results The 1, 2, 3 year survival rates of the integrated group were 79.2%, 33.4%, 15.6%, 77.3%, 36.4%, 12.5% respectively. The two groups were partially uncontrolled, their recurrence and metastasis rates were similar (P> 0.05), and the non-cancer mortality group was significantly higher than that of the control group (P <0.05). Conclusion In vitro radiation combined with intracavitary radiotherapy and concurrent chemotherapy can not further improve the 3-year survival rate of locally advanced esophageal cancer.