CAJ | 학술논문

目的：探讨三维适形放疗联合同步化疗在局部晚期食管癌治疗中的近期有效率、毒副反应及生存率。方法：134例病人纳入本研究。采用三维适形放疗，常规分割，2.0Gy/次，1次/天，5天/周，放疗剂量50-70Gy。化疗为顺铂（DDP）75mg/m2第1天，静滴；氟尿嘧啶（5-FU）500mg/m2第1-4天，静滴，化疗在放疗第1、29天进行，共两个周期。33例放化疗结束后再原方案化疗1个疗程，36例放化疗结束后再原方案化疗2个疗程，64例放化疗结束后无化疗。结果：134例患者近期有效率为73.9％，1、2及3年的生存率分别为80.5％、61.5％和47.0％。同期放化疗后再化疗1、2个疗程及无化疗的中位生存时间分别为41、62和30个月（P＝0.493）。毒副反应主要是放射性食管炎，其次是血液毒性及胃肠道反应，患者均能耐受。结论：对失去了手术机会，评分较好的局部晚期食管癌患者，可考虑给予同期放化疗。毒副反应病人可以耐受。放疗后再化疗2个疗程可能对生存有获益。
목적：탐토삼유괄형방료연합동보화료재국부만기식관암치료중적근기유효솔、독부반응급생존솔。방법：134례병인납입본연구。채용삼유괄형방료，상규분할，2.0Gy/차，1차/천，5천/주，방료제량50-70Gy。화료위순박（DDP）75mg/m2제1천，정적；불뇨밀정（5-FU）500mg/m2제1-4천，정적，화료재방료제1、29천진행，공량개주기。33례방화료결속후재원방안화료1개료정，36례방화료결속후재원방안화료2개료정，64례방화료결속후무화료。결과：134례환자근기유효솔위73.9％，1、2급3년적생존솔분별위80.5％、61.5％화47.0％。동기방화료후재화료1、2개료정급무화료적중위생존시간분별위41、62화30개월（P＝0.493）。독부반응주요시방사성식관염，기차시혈액독성급위장도반응，환자균능내수。결론：대실거료수술궤회，평분교호적국부만기식관암환자，가고필급여동기방화료。독부반응병인가이내수。방료후재화료2개료정가능대생존유획익。
Objective:To evaluate the therapeutic effect,toxicity and survial rate of three dimensional-conformal radiotherapy(3D-CRT)combined with chemotherapy for locally advanced cancer of the esophagus. Methods:Total of 134 patients with locally advanced cancer of the esophagus were analysed retrospectively. All patients received 3D-CRT combined with chemotherapy DF(DDP and 5-FU),the total tumor does were 50-70Gy. 33 patients contin-ued chemotherapy with original scheme 1 course,36 patients continued chemotherapy with original scheme 2 courses, and 64 cases were without chemotherapy after radiation and chemotherapy. Results:The overall response( CR﹢PR) rate was 73. 9%. The one-year,two-year and there-year survival rates for all patients were 80. 5%,61. 5% and 47. 0%,respectively. After concurrent radiochemotherapy and chemotherapy 1 course,2 courses and without chemo-therapy,the median survival time was 41 months,62 months and 30 months(P=0. 493),respectively. The main ad-verse reactions were radioactive esophagitis,followed by hematotoxicity and gastrointestinal reactions,but they were tolerable. Conclusion:Synchronic radiochemotherapy could be given when patients lost operation chance,and had high score. Adverse reaction of patients can be tolerated. Chemotherapy 2 courses may have survival benefit after syn-chronic radiochemotherapy.