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目的评价3种治疗模式对中晚期食管癌的临床疗效和毒性反应。方法对解放军264医院2011年3月—2013年3月收治的采用3种治疗模式[同步放化疗组(n=36)、序贯放化疗组(n=43)、单纯放疗组(n=39)]治疗的中晚期食管癌118例的临床资料进行回顾性分析。结果①近期疗效:近期有效率同步放化疗组(91.7%)、序贯放化疗组(65.1%)显著高于单纯放疗组(46.2%)(P<0.05),同步放化疗组显著高于序贯放化疗组(P<0.05)。②远期疗效:3组1年生存率分别为83.3%、74.4%、69.2%,差异无统计学意义(P>0.05);2年生存率同步放化疗组(50.0%)与序贯放化疗组(41.9%)显著高于单纯放疗组(20.5%)(P<0.05),前两组差异无统计学意义(P>0.05)。③毒性反应:同步放化疗组、序贯放化疗组骨髓抑制、食管炎、放射性肺炎、恶心呕吐发生率均显著高于单纯放疗组(P<0.05),而同步放化疗组、序贯放化疗组上述毒性反应发生率差异无统计学意义(P>0.05)。结论同步放化疗治疗中晚期食管癌效果优于序贯放化疗及单纯放疗,虽不良反应增多,但多数患者可耐受。
Objective To evaluate the clinical efficacy and toxicity of three treatment modalities on advanced esophageal cancer. METHODS: Three treatment modalities (synchronous radiotherapy and chemotherapy group (n = 36), sequential radiotherapy and chemotherapy group (n = 43) and radiotherapy alone group (n = 39) were enrolled in the PLA 264 Hospital from March 2011 to March 2013 )] Treatment of advanced esophageal cancer in 118 cases of clinical data were retrospectively analyzed. Results ① The short-term curative effect: The rate of concurrent chemoradiotherapy (91.7%), sequential radiochemotherapy (65.1%) was significantly higher than that of radiotherapy alone (46.2%) (P <0.05) Radiotherapy group (P <0.05). ② Long-term efficacy: The 3-year 1-year survival rates were 83.3%, 74.4% and 69.2% respectively, with no significant difference (P> 0.05). The two-year survival rate was significantly higher in the concurrent chemoradiation group (50.0% (41.9%) was significantly higher than that of radiotherapy alone (20.5%) (P <0.05). There was no significant difference between the two groups (P> 0.05). (3) Toxicity: The incidences of myelosuppression, esophagitis, radiation pneumonitis and nausea and vomiting were significantly higher in the concurrent chemoradiation group than those in the radiotherapy alone group (P <0.05), while those in the concurrent radiochemotherapy group, sequential radiochemotherapy There was no significant difference in the incidence of these toxic reactions (P> 0.05). Conclusions Simultaneous chemoradiotherapy is superior to sequential chemoradiotherapy and sequential radiotherapy in the treatment of advanced esophageal cancer. Although the adverse reactions increase, most patients can tolerate it.