术后放疗与术后同步放化疗治疗食管癌临床研究  

Clinical analysis of postoperative radiotherapy and postoperative concurrent chemoradiotherapy after radical surgery of thoracic esophageal squamous cell carcinoma

作　　者：邓霞[1] 张萍[1] 谢聪颖[1] 

机构地区：[1]温州医学院附属第一医院放化疗科,浙江温州325000

出　　处：《实用肿瘤杂志》2013年第3期294-298,共5页Journal of Practical Oncology

摘　　要：目的探讨食管癌根治术后患者采用单纯放疗与同步放化疗的疗效差异。方法Ⅱ～Ⅲ期食管癌根治术后患者共101例,分为单纯放疗组(n=49)和同步放化疗组(n=52),全部患者在术后4-6周内给予放疗,放疗总量50 Gy,2.0 Gy/次,1次/d,共25次,5周完成;同步放化疗组在放疗的第1周和第4周接受紫杉醇联合顺铂方案化疗,紫杉醇135 mg/m2,第1天;顺铂20 mg/m2,第1-3天。结果单纯放疗组1、3、5年生存率和中位生存时间分别为85.3%、42.0%、38.5%和27.2月,同步放化疗组分别为92.2%、49.1%、42.1%和34.1月(P=0.328);Ⅲ期患者单纯放疗组和同步放化疗组3年无瘤生存率分别为9.5%、34.7%(P=0.015);3年生存率分别为7.7%、32.5%(P=0.047)。结论与单纯放疗比较,同步放化疗可延长Ⅲ期食管癌根治术后患者的无瘤生存时间,提高3年生存率。Objective To analyze treatment outcome of postoperative radiotherapy （RT） and postoperative concurrent chemoradiotherapy （CRT） in patients with stage Ⅱ-Ⅲ esophageal carcinoma. Methods One hundred and one patients who underwent radical surgery with stage Ⅱ-Ⅲ esophageal carcinoma were assigned to postoperative RT group （ n = 49 ） and postoperative CRT group （ u = 52）. All patients were irradiated with 50 Gy in 25 fractions in 5 weeks 4 - 6 weeks after operation. The patients of CRT group received two cycles of paclitaxel 135 mg/㎡dl and eisplatin 20 mg/㎡ d 1 - 3 in the fist and fourth weeks of external radiation. Results The median survival time for the patient in CRT group and RT group was 34. 1 months and 27. 2 months, respectively. 1-,3-,5-year overall survival rates of RT group were 85.3% , 42. 0% , 38.5% ,compared with 92.2% , 49. 1% , 42. 1% of CRT group（P =0. 328）. For stage Ⅲ patients, the 3-year disease-free survival rate was 9. 5% in RT group and 34. 7% in CRT group（P =0. 015） , respectively. The 3-year overall survival rate of patients in RT group was 7.7% and 32. 5% in CRT group（P = 0. 047）. Conclusion Compared with postoperative radiotherapy, postoperative concurrent ehemoradiotherapy could prolong 3-year disease-free survival rate and improve 3-year overall survival rate for patients undergoing radical surgery with stage Ⅲ esophageal squamous cell carcinoma.

关 键 词：食管肿瘤 放射疗法 食管肿瘤 外科学 食管肿瘤 药物疗法 手术后期间 综合疗法 抗肿瘤联合化疗方案 

分 类 号：R735.1[医药卫生—肿瘤]