同期放化疗联合辅助化疗与单纯同期放化疗治疗非手术局部晚期食管鳞癌的疗效及安全性对比

目的 对比同期放化疗联合辅助化疗与单纯同期放化疗治疗非手术局部晚期食管鳞癌的疗效及安全性.方法 回顾性分析102例局部晚期食管鳞癌非手术患者的临床资料,其中采用同期放化疗联合辅助化疗(观察组)49例,同期放化疗(对照组)53例.放疗技术采用三维适形或调强放疗,同期化疗或辅助化疗方案采用顺铂及5-氟尿嘧啶方案或顺铂及紫杉醇方案.比较两组近期疗效、生存情况及急性毒副反应发生情况.结果 观察组、对照组总有效率分别为91.8％、88.7％,差异无统计学意义(P>0.05).观察组的1、2、3年生存率分别为87.6％、64.9％、44.1％,对照组的1、2、3年生存率分别为76.8％、50.6％、30.6％,两组比较差异无统计学意义(P>0.05).观察组的1、2、3年无进展生存率分别为71.9％、50.8％、15.1％,中位无进展生存期分别为20个月,对照组的1、2、3年无进展生存率分别为60.1％、26.3％、7.8％,中位无进展生存期分别为13.5个月,观察组的无进展生存情况优于对照组(P<0.05).两组放疗期间3级以上急性毒副反应总发生率及各项毒副反应发生情况比较,差异均无统计学意义(P>0.05).结论 同期放化疗联合辅助化疗可延长非手术局部晚期食管鳞癌患者的无进展生存期,且不增加急性毒副反应的发生率.

Comparison of efficacy and safety between concurrent chemoradiotherapy combined with adjuvant chemotherapy and concurrent chemoradiotherapy alone for treatment of unresectable locally advanced esophageal squamous cell carcinoma

Objective To compare the efficacy and safety between concurrent chemoradiotherapy ( CCRT) combined with adjuvant chemotherapy ( AC) and CCRT alone for the treatment of patients with unresectable locally advanced esophageal squamous cell carcinoma . Methods Clinical data of 102 patients pathologically diagnosed as unresectable locally advanced esophageal squamous cell were retrospectively analyzed.Forty-nine patients(observation group) and 53 patients(control group) were treated with CCRT combined with AC and CCRT alone respectively .The radiotherapy included three-dimensional conformal radiotherapy or intensity-modulated radiation therapy .Cisplatin combined with 5-fluorouracil or with paclitaxel were used as the regimen of concurrent chemotherapy or adjuvant chemotherapy .The short-term efficacy,survival and acute toxicity were compared between the two groups .Results The total effective rates of the observation group and the control group were 91.8％and 88.7％respectively,and no significant difference was found between the two groups(P>0.05).There were no significant differences in the 1-,2-or 3-year survival rate between the observation group (87.6％,64.9％ and 44.1％ respectively) and the control group(76.8％,50.6％and 30.6％respectively)(P>0.05).The 1-,2-and 3-year progression-free survival rates and median progression-free survival of the observation group were 71.9％,50.8％,15.1％and 20 months respectively.The 1-,2-and 3-year progression-free survival rates and median progression-free survival of the control group were 60.1％,26.3％,7.8％ and 13.5 months respectively.The progression-free survival of the observation group was superior to that of the control group (P<0.05).There were no significant differences in the overall incidence rate of grade 3 acute toxicity or severer ,or the incidence rate of each acute toxicity during radiotherapy between the two groups (P >0.05).Conclusion CCRT combined with AC can prolong the progression-free survival but does not increase the incidence rate of acute toxicity for patients with unresectable locally advanced esophageal squamous cell carcinoma .