COMBINED CHEMOTHERAPY AND RADIOTHERAPY COMPARED WITH RADIOTHERAPY ALONE IN PATIENTS WITH CANCER OF THE ESOPHAGUS
COMBINED CHEMOTHERAPY AND RADIOTHERAPY COMPARED WITH RADIOTHERAPY ALONE IN PATIENTS WITH CANCER OF THE ESOPHAGUS
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DOI：
10.1056/nejm199206113262403
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发表时间：
1992-06-11
影响因子：
158.5
通讯作者：
EMAMI, B
中科院分区：
文献类型：
--
作者：
HERSKOVIC, A;MARTZ, K;EMAMI, B
背景。手术和放疗对食管癌的常规治疗效果有限。中位生存期不到10个月，只有不到10%的患者能存活5年。近期研究表明，化疗与放疗联合可能会提高生存率。
方法。这项Ⅲ期前瞻性、随机、分层试验旨在评估氟尿嘧啶（每日每平方米体表面积1000毫克，连用4天）和顺铂（第1天每平方米75毫克）联合4个疗程并加用5000 cGy放疗，与单纯6400 cGy放疗相比，对胸段食管鳞状细胞癌或腺癌患者的疗效。在121例患者的累积结果显示接受化疗和放疗的患者在生存率方面有显著优势后，该试验停止。
结果。接受放疗的患者中位生存期为8.9个月，而接受化疗和放疗的患者为12.5个月。在前一组中，12个月和24个月的生存率分别为33%和10%，而在接受联合治疗的患者中分别为50%和38%（P<0.001）。
Background. The efficacy of conventional treatment with surgery and radiation for cancer of the esophagus is limited. The median survival is less than 10 months, and less than 10 percent of patients survive for 5 years. Recent studies have suggested that combined chemotherapy and radiation therapy may result in improved survival.Methods. This phase III prospective, randomized, and stratified trial was undertaken to evaluate the efficacy of four courses of combined fluorouracil (1000 mg per square meter of body-surface area daily for four days) and cisplatin (75 mg per square meter on the first day) plus 5000 cGy of radiation therapy, as compared with 6400 cGy of radiation therapy alone, in patients with squamous-cell carcinoma or adenocarcinoma of the thoracic esophagus. The trial was stopped after the accumulated results in 121 patients demonstrated a significant advantage for survival in the patients who received chemotherapy and radiation therapy.Results. The median survival was 8.9 months in the radiation-treated patients, as compared with 12.5 months in the patients treated with chemotherapy and radiation therapy. In the former group, the survival rates at 12 and 24 months were 33 percent and 10 percent, respectively, whereas they were 50 percent and 38 percent in the patients receiving combined therapy (P