食管癌术后淋巴结阳性患者单纯放疗或同期放化疗疗效比较
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The efficacy comparison of concurrent chemoradiotherapy or radiotherapy alone in postoperative patient with N1 esophageal carcinoma
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    目的:研究食管癌术后伴淋巴结转移患者单纯放疗或同期放化疗的疗效-方法:68例食管中段和(或)上段癌术后伴淋巴结转移的患者用信封法随机分为单纯放疗组(RT,34例)和同期放化组(CRT 34例)-其中,RT组仅给予预防性放疗,总剂量54 Gy/27次-CRT组给予预防性放疗,总剂量54 Gy/27次,放疗期间给予顺铂(DDP)75 mg/m2,第1和29天,氟尿嘧啶(5-FU)2 000 mg/m2 96 h 持续滴注,第1~4和29~32天-结果:RT组和CRT组的1-3和5年总生存率分别为70.5%(24/34)-38.2%(13/34)-26.5%(9/34)和73.5%(25/34)-47.1%(16/34)-35.3%(12/34),χ2 = 0.842,P = 0.359-RT组和CRT组的1-3和5年无病生存率分别为58.8%(20/34)-26.5%(9/34)-14.7%(5/34)和64.7%(22/34)-47.1%(16/34)-26.5%(9/34),χ2 = 3.382,P = 0.066-CRT组的急性放化疗反应明显高于RT组,晚期放疗损伤无差异-结论:食管癌术后伴淋巴结转移患者同期放化疗较单纯放疗有提高生存率的趋势,但急性放化疗反应较重-

    Abstract:

    Objective: To study the efficacy of concurrent chemoradiotherapy or radiotherapy alone in postoperative patient with N1 esophageal carcinoma. Methods: From October 2003 to October 2005,68 eligible patients with N1 esophageal carcinoma were randomized into radiotherapy alone group(RT,34 cases) and concurrent chemoradiotherapy group(CRT,34 cases). The schedules of radiotherapy in both groups were same,with 3-DCRT with conventional fractionation,and total dose is 54 Gy. The regiment of chemotherapy for the CRT group was consisted of DDP and 5-Fu for 2 cycles . It started on the first day of radiotherapy and repeated since the 29 day. Results: The overall survival rates at 1-,3-,and 5-year were 70.5%,38.2%,and 26.5% in the RT group,73.5%,47.1%,and 35.3% in the CRT group,respectively(P = 0.359);and the disease-free survival rates at 1-,3-,and 5-year were 58.8%,26.5%,and 14.7% in the RT group,64.7%,47.1%,and 26.5% in the CRT group respectively. The acute toxicity of chemoradiotherapy in the CRT group were higher than the RT group;later toxicity of two groups were similar. Conclusion: There was a trend of better survival in postoperative patient with N1 esophageal carcinoma treated with CRT than with the RT alone. However,the acute toxicity of chemoradiotherapy in the CRT group was higher than the RT group.

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仲 琴,朱卫国,贾正飞,冯 永.食管癌术后淋巴结阳性患者单纯放疗或同期放化疗疗效比较[J].南京医科大学学报(自然科学版),2011,(10):1459-1462

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  • 收稿日期:2011-04-17
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