食管癌同步放化疗.ppt

JClinOncol.2002Mar1;20(5):1167-74.INT0123(RadiationTherapyOncologyGroup94-05)phaseIIItrialofcombined-modalitytherapyforesophagealcancer:high-doseversusstandard-doseradiationtherapy.西安交通大学医学院第二附属医院SECONDAFFILIATEDHOSPITALOFMEDICALCOLLEGEOFXI’ANJIAOTONGUNIVERSITYPURPOSE:Tocomparethelocal/regionalcontrol,survival,andtoxicityofcombined-modalitytherapyusinghigh-dose(64.8Gy)versusstandard-dose(50.4Gy)radiationtherapyforthetreatmentofpatientswithesophagealcancer.PATIENTSANDMETHODS:Atotalof236patientswithclinicalstageT1toT4,N0/1,M0squamouscellcarcinomaoradenocarcinomafourmonthlycyclesoffluorouracil(5-FU)(1,000mg/m(2)/24hoursfor4days)andcisplatin(75mg/m(2)bolusday1)withconcurrent64.8Gyversusthesamechemotherapyschedulebutwithconcurrent50.4Gy.Thetrialwasstoppedafteraninterimanalysis.RESULTS:Forthe218eligiblepatients,therewasnosignificantdifferenceinmediansurvival(13.0v18.1months),2-yearsurvival(31%v40%),orlocal/regionalfailureandlocal/regionalpersistenceofdisease(56%v52%)betweenthehigh-doseandstandard-dosearms.CONCLUSION:Thehigherradiationdosedidnotincreasesurvivalorlocal/regionalcontrol.RTOG9405第31页,共61页，星期六，2024年，5月RTOG0113.试验fluorouracil,cisplatin,andpaclitaxel诱导化疗然后fluorouracil＋paclitaxel＋50.4GyRT(armA)(37/41)paclitaxelpluscisplatin诱导化疗然后fluorouracil＋paclitaxel＋50.4GyRT(armB)(35/43).结果中位生存时间28.7months(armA)，14.9months(armB)1年生存率75.7%(armA)，2年生存率56%(armA)37%(armB)3级毒性(armA=54%,armB=43%)4级毒性(armA=27%,armB=40%)死亡(armA=3%,armB=6%)但没有达到77.5%目标.西安交通大学医学院第二附属医院SECONDAFFILIATEDHOSPITALOFMEDICALCOLLEGEOFXI’ANJIAOTONGUNIVERSITYJClinOncol.2008Oct1;26(28):4551-6.Epub2008Jun23PhaseIIrandomizedtrialoftwononoperativeregimensofinductionchemotherapyfollowedbychemoradiationinpatientswithlocalizedcarcino