同步放化疗治疗老年中晚期食管癌108例临床观察

目的探讨老年食道癌放化疗的最佳治疗方案。方法选择215例老年食道癌患者，随机分为治疗组108例和对照组107例。两组均采用常规分割放疗，达40GY后追加肿瘤剂量至55～65GY，6～7周完成。治疗组同步用小剂量替加氟0．7g／d，每周5次，至放疗结束，联合DDP（顺铂），一般2个周期。结果治疗组与对照组有效率分别为91．7％（99／108）、82．2％（88／107），两组比较差异有显著性（x^2=4．2139，P〈0．05）；1、2、3年生存率治疗组分别为78．7％、54．6％、38．0％，对照组分别为52.3％、25．2％、17．8％，两组比较差异非常显著，治疗组疗效明显优于对照组（P〈0．01）。毒副反应治疗组较对照组明显增多且较重，但很少超过Ⅱ度，均未影响治疗进度。结论放疗同步应用替加氟＋DDP小剂量持续化疗治疗老年食管癌能提高疗效，延长生存期，且耐受性较好，是临床治疗老年食道癌的良好方案。

Concomitant Radiotherapy and Chemotherapy for Eelderly Patients with Advanced Esophageal Cancer; A Clinical Observation of 108 Cases

Objective To evaluate the efficacy and toxicity of concomitant radiotherapy and chemotherapy in the treatment of advanced esophageal cancer in the elderly. Methods We selected 215 elderly patients with advanced esophageal cancer and randomly divided them into control group（n=107） receiving single radiotherapy and treatment group（n=108） receiving normal radiotherapy plus tegafur 0.7g one time a day, five times a week. DDP20mg, first 1 - 5 days, 21 days as a cycle and 2 cycles for all patients. Results The response rate was 91.7% （99/108） in the treatment group and 82.2% （88/107） in the control group （x^2=4.2139,P〈0.05）. 1-, 2- and 3- year survival rates were 78.7%, 54.6% and 38.0%, respectively in the treatment group and 52.3%, 25.2% and 17.8% in the control group（P〈0.01 ）. And the side-effects were increased in the treatment group compared with the control group, with no obvious damage of grade Ⅲ - Ⅳ and no one was delayed in the therapy due to the toxicity. Conclusion Radiotherapy combined with concomitant low dosage tegafur plus cisplatin can improve response rates, and shows longer survival time , higher safety and better tolerance. It is a good method in the treatment of elderly patients with advanced esophageal cancer.