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目的 探讨放射治疗后配合DF方案化疗对食管癌的治疗价值。方法 将 192例食管癌患者随机分为 2个组行前瞻性临床研究。一组 96例行放射治疗后配合DF方案化疗 (综合组 ) ,另一组 96例行单纯放射治疗 (单放组 )。放射治疗采用 6MVX射线常规照射 ,DT6 0～ 70Gy ;化疗在放射治疗后 1个月内按计划每 3周行 1个周期。 2个组均随访 3年。结果 综合组与单放组 1,2 ,3年生存率分别为 6 1.5 % ,44 .8% ,34 .4%和 45 .8% ,31.3% ,18.8%。综合组 1,2 ,3年生存率明显高于单放组 (P <0 .0 5 ) ,且无严重毒副反应发生。 2个组局控率差异无显著意义 (P >0 .0 5 ) ,但远地转移率综合组明显低于单放组 (P <0 .0 5 )。放射治疗后晚期食管损伤 ,综合组显著高于单放组 (P <0 .0 1)。结论 放射治疗食管癌后配合DF方案化疗是疗效较好、值得临床进一步探索的治疗方法
Objective To investigate the therapeutic value of radiotherapy combined with DF chemotherapy for esophageal cancer. Methods 192 patients with esophageal cancer were randomly divided into two groups for prospective clinical studies. A group of 96 patients received radiotherapy followed by chemotherapy with DF regimen (comprehensive group) and another group of 96 patients received radiotherapy alone (single-release group). Radiotherapy was performed with conventional 6MV X-ray irradiation and DT6 0-70Gy. Chemotherapy was performed every 3 weeks as planned within 1 month after radiation therapy. Both groups were followed up for 3 years. Results The 1-, 2-, and 3-year survival rates of the comprehensive and radiotherapy groups were 61.5%, 44.8%, 34.4%, 45.8%, 31.3%, and 18.8%, respectively. In the comprehensive group, the 1-year and 2-year survival rates were significantly higher than those in the radiotherapy group (P < 0.05), and no serious adverse reactions occurred. There was no significant difference in the control rates between the two groups (P > 0.05), but the comprehensive rate of distant metastasis was significantly lower than that of the radiotherapy group (P < 0.05). Late esophageal injury after radiotherapy was significantly higher in the integrated group than in the radiotherapy group (P < 0.01). Conclusion Radiotherapy for esophageal cancer combined with DF regimen chemotherapy is a treatment method that is effective and worthy of clinical exploration