林佳 王继宇 许宏伟

【摘要】 目的：探究單纯三维适形放疗和放化同期治疗中晚期食管癌疗效。方法：选取2017年7月-2018年10月本院中晚期食管癌患者50例。依据治疗方案不同将其分为同期组、单纯组，各

25例。单纯组予以单纯三维适形放疗，同期组予以放化疗同期治疗。比较两组有效率、毒副反应发生率、治疗前及治疗后3个月生存质量评分。结果：同期组近期治疗有效率84.00%，高于单纯组的56.00%（P<0.05）;两组放射性食管炎、放射性气管炎、血小板减少及心脏毒性发生率比较，差异均无统计学意义（P>0.05），同期组白细胞计数下降及肝功能损害发生率均高于单纯组（P<0.05）;治疗后3个月，同期组躯体、情绪、角色、认知、社会功能评分均高于单纯组，总体症状评分低于单纯组，差异均有统计学意义（P<0.05）。结论：对中晚期食管癌患者予以放化疗同期治疗，可显著提高患者有效率，明显改善生存质量，值得临床推广与应用。

【关键词】 食管癌; 中晚期; 单纯三维适形放疗; 放化同期治疗

【Abstract】 Objective：To investigate the efficacy of simple three-dimensional conformal radiotherapy and concurrent radiotherapy and chemotherapy in treatment of advanced esophageal cancer.Method：A total of

50 patients with advanced esophageal cancer in our hospital from July 2017 to October 2018 were enrolled.According to the different treatment schemes，they were divided into synchronization group and simple group，25 cases in each group.Simple group was treated with simple three-dimensional conformal radiotherapy，synchronization group was treated with concurrent radiotherapy and chemotherapy.The effectiveness，incidence of toxicity and side effects，quality of life scores before and 3 months after treatment between two groups were compared.Result：The short-term effective rate in synchronization group was 84.00%，which was higher than 56.00% in simple group（P<0.05）.The incidence of radiation esophagitis，tracheitis，thrombocytopenia and cardiotoxicity between two groups were compared，the differences were not statistically significant（P>0.05），the incidence of leukocyte count decrease and liver function damage in synchronization group were higher than those of simple group（P<0.05）.3 months after treatment，the scores of physical，emotional，role，cognitive and social functions in synchronization group were higher than those of simple group，and the overall symptom score was lower than that of simple group，the differences were statistically significant（P<0.05）.Conclusion：The concurrent treatment of radiotherapy and chemotherapy for patients with advanced esophageal cancer can significantly improve the patients efficiency and quality of life，which is worthy of clinical promotion and application.

【Key words】 Esophageal cancer; Advanced stage; Simple three-dimensional conformal radiotherapy;Concurrent radiotherapy and chemotherapy treatment

First-authors address：The Peoples Hospital of Jieyang City，Jieyang 522000，China

doi：10.3969/j.issn.1674-4985.2019.16.011

食管癌为临床常见恶性肿瘤之一，具有极高发病率，且近年来受多种因素影响，该病发病率呈明显增长趋势，受到临床高度重视[1-2]。食管癌早期无典型临床症状，多数患者确诊时已进展至中晚期，错失最佳手术治疗时机，使得放射治疗成为该病主要治疗手段，但相关研究表明，常规放疗受肿瘤局部复发影响，5年生存率仅约10%[3-4]。近年来随着放疗设备的更新及技术的改进，三维适形放疗逐渐成为放射治疗首选方法。研究表明，同步放化疗可明显提高晚期宫颈癌、肺癌、头颈部鳞癌、直肠癌等多种恶性肿瘤局部控制率及生存率[5-6]。本研究为进一步提高治疗效果，选取50例中晚期食管癌患者，对比分析单纯三维适形放疗和放化同期治疗中晚期食管癌疗效，现报道如下。

1 资料与方法

1.1 一般资料 选取2017年7月-2018年10月本院中晚期食管癌患者50例。（1）纳入标准：均符合第八版《內……