Efficacy of chemotherapy combined with radiotherapy for advanced esophageal carcinoma

Objective To study the comparative efficacy between radiotherapy combined with chemotherapy and radiotherapy alone in treatment of patients with advanced esophageal cancer.Methods 148 patients with advanced esophageal cancer were randomized into two groups,76 patients treated with chemotherapy combined with radiotherapy(CT and RT) and 72 patients with radiotherapy alone(RT).The chemotherapy regimen included CF 100-200 mg on d1-5,5-fluorouracid 500 mg/(m~2·d) on d1-5, cisplatin 25 mg/(m~2·d) on d1-3. Three to seven days after chemotherapy,the patients were irradiated through anteroposterior(AP) and posteroanterior(PA) fields to a dose of 40-44 Gy in 4.0-4.4 weeks by 8MV X ray,and then chemotherapy was repeated again,followed by a boosting dose of 24-26 Gy in (2.4-)2.6 weeks through oblique fields. Results The 1-,3- and 5- year survival rates were 73.7%,31.5% and 15.8% in the CT and RT group and 61.1%,16.7% and 5.5% in the RT group. The differences of 3- and 5- year survival rates were statistically significant(P0.05).The toxic and side effects of the CT and RT group were more severe than those of the RT group. The main cause of death was local recurrence and the next cause was distant metastasis in the two groups.The difference was not statistically significant (P0.05).Conclusion The inductive chemotherapy with 5-fluorouracil,cisplatin and CF combined with radiotherapy might improve the treatment efficacy of esophageal cancer and lengthen the survival time.The toxic and side effects of the combined modality were more severe than those of radiotherapy alone ,but they were well tolerable.