调强放疗联合同步化疗治疗中晚期食管癌的疗效分析

目的 比较分析调强放疗并同步化疗与常规放疗并同步化疗治疗中晚期食管癌的疗效及毒性不良反应,探讨调强放疗并同步化疗对中晚期食管癌的治疗价值.方法 选择2008年1月～2011年12月间收治的同步放化疗中晚期食管癌患者200例,用随机配对法分为两组：调强放疗联合同步化疗组（调强放疗组）92例和常规二维适形放疗联合同步化疗组（常规放疗组）108例.结果 调强放疗组和常规放疗组的有效率分别为96.7％和85.2％ （P=0.005）,两组3年的总生存率、无局部区域复发生存率和无进展生存率分别为63.6％对38.9％、68.7％对41.2％和56.2％对30.8％,调强放疗组均好于常规放疗组（P＜0.0001）.调强放疗组与常规放疗组比较降低了区域淋巴结转移率和原发瘤床复发率和总复发转移率（P＜0.05）,远处转移率及毒性不良反应两组比较,差异无统计学意义（P＞0.05）.结论 调强放疗联合紫杉醇加铂类方案同步化疗较常规放疗联合同步化疗明显降低局部复发率、提高总生存率、无局部区域复发生存率和无进展生存率.

Treatment Results Analysis of Advanced Esophageal Carcinoma Underwent Intensity-modulated Radiotherapy Concurrent with Chemotherapy

Objective To analyze the treatment result and toxic side-effect of intensity-modulated radiotherapy （IMRT） concurrent with chemotherapy versus conventional radiotherapy （CRT） concurrent with chemotherapy for advanced esophageal carcinoma （EPC）,and to probe the value of IMRT concurrent with chemotherapy for advanced EPC.Methods A total of 200 advanced EPC patients underwent radiotherapy with chemotherapy between January 2008 and December 2011,and they were divided into two groups at random with matched pair technique：92 patients of IMRT concurrent with chemotherapy （IMRT group） and CRT concurrent with chemotherapy （CRT group）.Results The effective rates were 96.7％ in IMRT group and 85.2％ in CRT group respectively （P =0.005）.Three year overall survival rates,local region relapse-free survival rates and progression-free survival rates were 63.6％ versus 38.9％,68.7％ versus 41.2％ and 56.2％ versus 30.8％,which memt that IMRT group was better than CRT group （P ＜ 0.0001）.Compared with CRT group,IMRT group reduced metastatic rates of regional lymph nodes,recurrence rate of primary tumor-bed and overall relapse and metastasis rates （P ＜ 0.05）.But distant metastatic rate and toxic side-effect had no significant difference （P ＞ 0.05）.Conclusion IMRT concurrent with chemotherapy （taxol plus platinum） could markedly reduce regional recurrence,and could improve overall survival rates,local region relapse-free survival rates and progression-free survival rates.