三维适形放疗不同联合方式治疗中晚期食管癌的对比研究

目的：观察三维适形放疗不同联合方式治疗中晚期食管癌的临床疗效、生存率、毒副反应。方法：将90例经病理证实的未治疗的中晚期食管癌患者随机分成单纯放疗组、放化疗组、放化热疗组3组各30例，分别采用相应的联合方式治疗，治疗结束后3个月评估近期疗效和毒副反应，随访结束后评估远期疗效。结果：治疗总有效率单纯放疗组为46．7％，放化疗组为63．3％，放化热疗组为86．7％，3组比较差异有统计学意义（P〈0．05）。3组1年生存率依次为50％、66．7％、86．7％，3组比较差异有统计学意义（P〈0．05）。单纯放疗组放射性食管炎、放射性肺炎、骨髓抑制发生率明显低于放化疗组及放化热疗组，差异有统计学意义（P〈0．05）。结论：放化疗联合体外高频热疗治疗中晚期食管癌，有效率和生存率进一步提高，毒副反应可耐受。

Comparative study of different combinations of the three- dimensional conformal radiotherapy in the treatment of advanced esophageal carcinoma

Objective： To observe the clinical curative effect, survival rate and adverse reaction of advanced esophageal carcinoma, we applied different combinations of the three-dimensional conformal radiotherapy. Methods： 90 cases of advanced esophageal carcinoma confirmed by pathology were divided randomly into radiotherapy group （ n = 30 ）, chemoradiotherapy group （ n After three months of treatment, the near future curative 30 ）, hyperthermochemoradiotherapy group （ n = 30 ）. effect and adverse reaction were evaluated;the long-term curative effect was determined at the end of follow-up. Results： Radiotherapy group had an effective rate of 46.7%. Chemoradiotherapy group 63.3%, Hyperthermochemoradiotherapy group 86. 7%, the differences among the three groups were statistically significant（P 〈0. 05）. One year survival rate in each group were 50%, 66. 7%, 86. 7% ,with statistical significance （P 〈 0. 05）. The incidence of radiation esophagitis, radiation pneumonitis, bone marrow suppression of radiotherapy group was significantly lower than chemotherapy group and hyperthermochemoradiotherapy group with significant difference （ P 〈 0. 05 ）. Conclusion： Chemoradiotherapy combined with external high frequency thermotherapy in the treatment of advanced esophageal carcinoma further improves effective rate and survival rate with tolerated adverse reactions.