IGRT 联合 DP 同步化疗治疗局部晚期食管癌的临床疗效评价

目的：研究图像引导调强放疗联合 DP 方案治疗局部晚期食管癌患者近期疗效、急性不良反应和总生存率的改善。方法：选择2012年1月~2015年9月南华大学附属第一医院放疗科收治的61例老年食管癌患者，随机分为单纯放疗组30例（单纯放疗组）和放疗同步 DP 方案组31例（放化疗组）。放化疗组给予 DP 方案同步化疗，两组均给予6MV-X 图像引导下调强放疗。比较两组近期疗效、急性不良反应发生率、3年生存率。结果：放化疗组总有效率为83.87％明显高于单纯放疗组56.7％；放化疗组局部晚期食管癌患者的3年生存率明显高于单纯放疗组；放化疗组骨髓抑制明显高于单纯放疗组；而二组患者的消化道反应和放射性食管炎差异无统计学意义，但都能顺利完成治疗。结论：图像引导调强放疗联合 DP 方案化疗治疗局部晚期食管癌近期疗效确切，能明显提高患者3年生存率，且毒副反应可耐受。

Evaluation of clinical efficacy of IGRT combined with DP in treatment of locally advanced esophageal carcinoma

Objective The short-term effect, acute adverse reaction and overall survival of patients with local advanced esophageal carcinoma were investigated, which were treated by the combination of DP and image-guided intensity-modulated radiotherapy. Methods 61 cases of elderly patients with esophageal cancer from First Hospital Affiliated to University of South China from September 2015 to January 2012 were randomly divided into two groups including 30 cases (radiation group) and 31 cases (DP and radiation group). DP and radiation group was given to the DP and radiation regimen, and the two groups were given the 6MV-X image-guided intensity-modulated radiotherapy. Two groups were compared with short-term efficacy, the incidence of acute adverse reactions and 3 year survival rate. Results The total effective rate in the DP and radiation group was 83.87%, which was significantly higher than that of radiotherapy, only 56.7%. And the 3 year survival rate of the DP and radia-tion group were significantly higher than that in the radiotherapy group in the patients with advanced esophageal carcinoma. The inhibition of bone marrow suppression in the chemotherapy group was significantly higher than that of the radiation group, while the two groups had no significant difference in the digestive tract reaction and radiation esophagitis. But they were able to complete the treatment successfully. Conclusion Image guided intensity modulated radiotherapy combined with DP regimen chemotherapy is effective to locally advanced esophageal cancer and can significantly improve the survival rate of 3 years. And the toxicity can be tolerated.