Clinical effect of concurrent chemoradiotherapy of cisplatin and 5-fluorouracil on locally advanced esophageal carcinoma

Objective:To evaluate the effectiveness and toxicity of concurrent chemoradiotherapy on locally advanced esophageal carcinoma. Methods:Forty-nine cases with locally advanced esophageal carcinoma were randomized into the first group(24 cases) treated only with radiotherapy and the second group(25 cases) treated with chemoradiotherapy combined cisplatin(20 mg/m2 day 1-4) and 5-fluorouracil(500 mg/m2 day 1-5).All cases were irradiated with60CO or 6MV-X ray.The radiation dose of the first group was 60-68 Gy in tumor for 30-34 times and sustained 6.0-6.5 weeks.The radiation dose of the second group was 54-60 Gy in tumor for 27-30 times and sustained 5.5-6.0 weeks,and 50-60 Gy,25-30 times and sustaining 5.0-6.0 weeks for regional lymph nodes.The second group were injected droply with 5-fluorouracil(500 mg/m2) for 5 days and cisplatin(20 mg/m2) for 4 days. Results:The effective rates of chemoradiotherapy group and radiotherapy group were 92.00% and 79.17%,respectively,the difference of the effective rates had no statistically significance(P0.05).The 1-year,2-year overall survival rate(OS) and locoregional progression-free survival(LPFS) of chemoradiotherapy group and radiotherapy group were 68.00%,32.00% and 58.33%,20.80%,and 72.00%,36.00% and 66.62%,25.00%,respectively.The LPFS and OS had no statistically significant difference between the two groups(P0.05).The toxicity of chemoradiotherapy group was heavier than the radiotherapy group,but the most patiens were tolerable. Conclusions:The chemoradiotherapy combined cisplatin and 5-fluorouracil can enhance the survival rate of patiens with locally advanced esophageal carcinoma and the adverse response is tolerable.