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三维适形放疗不同联合方式治疗中晚期食管癌的对比研究
作者:蔡君东1  刘晶2  曾淑超1  崔燕利3  李静海4  王瑞芳5 
单位:1. 河北省承德市第三医院 肿瘤科, 河北 承德 067000;
2. 河北省承德市妇幼保健院, 河北 承德 067000;
3. 河北省平泉县党坝中心卫生院, 河北 平泉 067500;
4. 河北省承德市双滦区医院, 河北 承德 067000;
5. 北京市通州区263医院, 北京 100000
关键词:三维适形 奈达铂 热疗 化疗 食管癌 
分类号:R735.1
出版年·卷·期(页码):2014·33·第一期(40-44)
摘要:

目的:观察三维适形放疗不同联合方式治疗中晚期食管癌的临床疗效、生存率、毒副反应。方法:将90例经病理证实的未治疗的中晚期食管癌患者随机分成单纯放疗组、放化疗组、放化热疗组3组各30例,分别采用相应的联合方式治疗,治疗结束后3个月评估近期疗效和毒副反应,随访结束后评估远期疗效。结果:治疗总有效率单纯放疗组为46.7%,放化疗组为63.3%,放化热疗组为86.7%,3组比较差异有统计学意义(P<0.05)。3组1年生存率依次为50%、66.7%、86.7%,3组比较差异有统计学意义(P<0.05)。单纯放疗组放射性食管炎、放射性肺炎、骨髓抑制发生率明显低于放化疗组及放化热疗组,差异有统计学意义(P<0.05)。结论:放化疗联合体外高频热疗治疗中晚期食管癌,有效率和生存率进一步提高,毒副反应可耐受。

Objective: To observe the clinical curative effect, survival rate and adverse reaction of advanced esophageal carcinoma, we applied different combinations of the three-dimensional conformal radiotherapy. Methods: 90 cases of advanced esophageal carcinoma confirmed by pathology were divided randomly into radiotherapy group(n=30),chemoradiotherapy group(n=30), hyperthermochemoradiotherapy group(n=30).After three months of treatment, the near future curative effect and adverse reaction were evaluated;the long-term curative effect was determined at the end of follow-up. Results: Radiotherapy group had an effective rate of 46.7%. Chemoradiotherapy group 63.3%, Hyperthermochemoradiotherapy group 86.7%, the differences among the three groups were statistically significant(P<0.05).One year survival rate in each group were 50%, 66.7%,86.7%,with statistical significance(P<0.05). The incidence of radiation esophagitis, radiation pneumonitis, bone marrow suppression of radiotherapy group was significantly lower than chemotherapy group and hyperthermochemoradiotherapy group with significant difference(P<0.05). Conclusion: Chemoradiotherapy combined with external high frequency thermotherapy in the treatment of advanced esophageal carcinoma further improves effective rate and survival rate with tolerated adverse reactions.

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