Chinese Medicine Combined With Radiotherapy And Chemotherapy Concurrent Treatment Of Esophageal Cancer Clinical Research And Experience

This dissertation is composed of two parts:the review articles and a clinical research.There are two review articles.The first one reviewed the clinical application of concurrent chemoradiotherapy in the treatment of esophageal carcinoma.The second one reviewed the clinical application of Traditional Chinese Medicine in the treatment of esophageal carcinoma.We conclude that concurrent chemoradiotherapy in the treatment of esophageal carcinoma could increase short-term effects,prolong survival time and improve the quality of life,and Traditional Chinese Medicine could prevent and treat the side effect of the concurrent chemoradiotherapy effectively,which is worth using in the clinic and conducting further research.The second part is a clinical study.Objective:To explore the clinical value of Traditional Chinese Medicine plus concurrent chemoradiotherapy in the treatment of upper and middle thoracic portion esophageal carcinoma.Method:Four patients with upper and middle thoracic portion esophageal carcinoma were treated with Traditional Chinese Medicine plus concurrent chemoradiotherapy.All the patients were treated for the first time and their general situations were fine,without local lymph node metastasis and distant metastasis.The radiotherapy adopted the three dimensional-conformal intensity modulated radiotherapy treatment planning system with 6MV-X ray linear electric actuator for percutaneous three-field irradiation.The patients were recieved 2-2.2Gy once a day from day 1 to day 15,21 days one cycle for 2 cycles.The total dose was 60-66Gy.Simultaneously the chemotherapy was given:Nedaplatin(NDP)40mg/m~2,by intravenous drip every day for first two days and 5-Fluorouracil(5-Fu)1000mg/m~2,by continuous intravenous pump for first five days,21 days one cycle for 2 cycles.After concurrent chemoradiotherapy,the patients received of NDP/5-Fu 2 cycles.During concurrent chemoradiotherapy,Traditional Chinese Medicine should be used to reduce the side of chemoradiotherapy and increase the curative effect with modified Gualou Xiebai Baijiu Tang and Siwu Tang.After concurrent chemoradiotherapy,the efficacy were evaluated based on "Response Evaluation Criteria in Solid Tumors(RECIST)"worked out by World Health Organization (WHO)in 1979.The side effect were also evaluated based on "Anti-cancer treatment drug acute and subacute toxicity grading criteria" worked out by World Health Organization(WHO)in 1981.Results:The short-term total effect rate was 100%.All the four patients were complete response(CR),and 2 patients of them were pathological complete response(PCR).The main adverse reaction were bone marrow suppression,gastrointestinal toxicity and liver and kidney dysfunction with gradeâ… -â…¡.Conclusion:Traditional Chinese Medicine plus concurrent chemoradiotherapy in the treatment of upper and middle thoracic portion esophageal carcinoma could increase short-term effects,improve the quality of life and shorten the treatment period,which is worth conducting further clinical research.