Efficacy of three-dimensional conformal concurrent radiotherapy and chemotherapy on advanced esophageal cancer

Objective To analyze the effect of three-dimensional conformal advanced esophageal concurrent chemoradiotherapy and simple three-dimensional conformal radiotherapy and toxicity. Methods From January 2007 to December 2009,362 cases of esophageal cancer were divided into three-dimensional conformal radiotherapy( radiation group) and three-dimensional conformal radiotherapy plus concurrent chemotherapy group( chemoradiotherapy group). Radiation therapy: the use of linear accelerator conformal irradiation,2 Gy / time,1 time / day,5 times / week; radiotherapy target dose: 60- 66 Gy / 30- 33 F /6-6. 5 weeks. Chemoradiotherapy group with paclitaxel( 150 mg / m2) + cisplatin( 80 mg/m2) combination chemotherapy,the first day and 29- day repeated; the first two days after the start of chemotherapy dimensional conformal conformal radiotherapy.The end of radiotherapy,continue line 1 to 2 cycles of consolidation chemotherapy. Results In the chemoradiotherapy group and radiation group,The complete remission rate was 41. 5% and 33. 2% respectively,efficiency( CR + PR) was 93. 3% and87. 4% respectively. In the concurrent chemoradiotherapy group and radiotherapy alone group,the 5-year local control rates were82. 6%,64. 4%,51. 2% and 72. 5%,51. 1%,35. 7%; 5-year survival rates were 77. 9%,49. 2%,36. 9% and 65. 3%,29. 3%,20. 4%. 5-year local control rate and survival rate were significantly higher in the chemoradiotherapy group than those of the radiotherapy alone group,there were significant differences( P 0. 05). Acute radiation reaction mainly concentrated in the0- 2 level. Among them,the incidence of grade 0- 1 acute radiation reaction in radiotherapy alone group was more than two groups and was significant( P 0. 05); acute radiation reaction occurs in chemoradiotherapy group was significant,there was significant difference between the two groups( P 0. 05); In low incidence of grade 3- 4,the two groups had no significant difference( P 0. 05). The incidences of radiation pneumonitis,esophageal fistula in the two groups were lower,and the two groups had no significant difference( P 0. 05). Failure reasons of treatment of esophageal cancer were still local recurrence and distant metastasis. Chemoradiotherapy group died of local control or recurrence rates were significantly lower compared with radiotherapy alone,and the difference was significant( P 0. 05). Chemoradiotherapy group of distant metastasis rate than radiotherapy alone group also decreased,but the difference was not significant( P 0. 05). Conclusion Three-dimensional conformal chemoradiotherapy can significantly improve the efficacy and long-term survival of patients with advanced esophageal squamous cell carcinoma,although it may increase the toxicity.