BASICAND CLINICAL RESEARCH ON CONCURRENT CHEMORADIOTHERAPY WITH PROTRACTED LOW DOSE CONTINUOUS INFUSION OF 5-FU + CDDP FOR ESOPHAGEAL CANCER

在流式细胞术的基础研究中，5-FU和CDDP联合作用72小时后，FM3A细胞出现明显的G_2M期积聚，长时间滞留在G_2期的细胞大多变成巨细胞或多核细胞，随后出现死亡。通过细胞生长分析、染料排斥试验和细胞形态分析，发现5-FU与顺铂联合放射治疗具有协同的细胞毒作用。在临床研究中，对1992~1994年间收治的31例II~III期食道癌患者同时采用小剂量5-PU持续输注放化疗(RT+5FU组)，并与27例单纯放疗组(RT组)进行比较。RT+5FU组的有效率和无局部进展率明显高于RT组(p&lt；0.05)。对1995.32例Ⅱ~Ⅲ期食道癌患者采用小剂量5-FU持续滴注(250rng/m2/d)加顺铂(3 mg/m2/d)同步放化疗(RTFC组)。RT+FC组的有效率、无局部进展率和累积生存率均显著高于RT组(p&lt；0.05)。我们的结论是，在II-III期食管癌的局部控制中，在整个常规放射治疗过程中持续小剂量持续滴注5-FU*CCDDP明显优于单纯常规放射治疗。

In the basic study using flow cytometry, a pronounced G_2M phase accumulation of FM3A cells was observed at 72 hours after the combined treatment of 5-FU and CDDP, Most of the cells blocked in G_2 phase for a long time became giant cells or multinuclear cells, which seemed todie later. Combining 5-FU plus CDDP with radiation showed synergistic cytotoxic effect on the experiments using cell growth analysis, dye exclusion test, and morphological analysis.In the clinical study, 31 patients with stage II - III esophageal cancer treated between 1992 and 1994 with the concurrent chemoradiotherapy using low-dose continuous infusion of 5-PU (RT+5FU group) were compared with 27 patients treated previously with radiotherapy alone (RT group). Response rate and local-progression free rate of the RT+5FU group were sigificantly higher than the RT group (p<0.05). Since 1995.32 patients with stage II - III esophageal cancer were treated with the concurrent chemoradiotherapy using low-dose continuous infusion of 5-FU (250 rng/m^2/day) plus CDDP (3 mg/m^2/day) (RTFC group). The RT+FC group showed response rate, local-progression free rate, and cummulative survival rate to be significantly higher than the RT group (p<0.05). We conclude that low-dose continuous infusion of 5-FU*CCDDP given during entire course of conventional radiotherapy is significantly superior to conventional radiotherapy alone in the local control of stage II - III esophageal cancer.