食管癌的外放射结合高剂量腔内放射治疗及同期化疗  

EXTERNAL IRRADIATION COMBINED WITH INTRACAVITARY RADIOTHERAPY AND CONCOMITANT CHEMOTHERAPY FOR ESOPHAGEAL CANCER

作　　者：江澜[1] 吴立洲[1] 王录全[1] 

机构地区：[1]中国人民武装警察部队江苏总队医院

出　　处：《中国癌症杂志》1999年第2期98-100,共3页China Oncology

基　　金：1998年全国武警部队立项课题

摘　　要：目的研究放射结合高剂量（ＨＤＲ）腔内放疗及同期化疗治疗食管癌的疗效。方法于１９９４年４月～１９９６年９月，９０例食管癌随机分为两组：４６例用６０Ｃｏ外照射，ＤＴ５０００～５５００ｃＧｙ，１周后，用ＨＤＲ１９２Ｉｒ腔内治疗１０００～１２００ｃＧｙ，ＰＦ化疗方案于第１、５６或６３天各给予一疗程（综合组）；４４例用６０Ｃｏ外照射，ＤＴ６０００～７０００ｃＧｙ（对照组）。结果一、三年生存率，综合组分别为８０％（３６／４６）、４１％（９／２２），对照组分别为３９％（１７／４４）、１１％（２／１８），生存率对比有显著性差异，综合组血液学毒副反应明显。结论外照射结合ＨＤＲ１９２Ｉｒ腔内放疗及同期化疗是晚期食管癌的有价值的综合治疗。PURPOSE To study the efficacy of external irradiation combined with high dose rate brachytherapy and concomitant chemotherapy for esophageal carcinoma. METHODS From April 1994 to September 1996,90 patients with esophageal carcinoma were treated. They were randomly divided into combined group(46 cases)and control group(44 cases).The combined treatment consisted of conventional radiotherapy to a total dose of 5 500 ～ 6 000 cGy.The chemotherapy regimen was a combination fo cisplatinum (DDP) 20 mg and fluorouracil(5 FU) 500～750 mg,from days 1～5.The cycles of concomitant chemotherapy were administered on days 1,56 or 63.Brachytherapy was delivered at 1 000 ～ 1 200 cGy one week after the end of external radiation therapy.The control group cases were treated by radiotherapy alone to a dose of 6 000 ～ 7 000 cGy. RESULTS The 1 ,3 year survial rates were 80%(36/46),41%(9/22) in the combined group and 39%(17/44),11%(2/18) in the control group.The differences in the rates were statistically significant in the two groups( P <0 01, P <0 05).In the combined group,the major side effect was hematological toxicity( P <0 05),but could be tolerated by the patients. CONCLUSIONS The results indicate that combined treatment could improve local control rates,and could play an important role in the management of advanced esophageal cancer.

关 键 词：食管癌 放射疗法 近距离放疗 药物疗法 

分 类 号：R735.105[医药卫生—肿瘤]