Comparison Of Concurrent Chemoradiotherapy And Sequential Chemoradiotherapy For Advanced Esophageal Carcinoma

Objective: To observe the efficacy and toxicity of concurrent chemoradiotherapyor sequential chemoradiotherapy for stageⅡ-Ⅲ esophageal carcinoma, and compare theefficacy between different nationalities. Methods:171patients with advancedesophageal carcinoma were randomly divided into two groups,86of them were treatedwith concurrent chemoradiotherapy and85of them in the sequential chemoradiotherapygroup were given chemotherapy after3weeks of radiotherapy. All the patients weretreated with three-dimensional conformal radiotherapy (3D-CRT, the total dose was56-64Gy and2Gy/time) combined with TP chemotherapy (cisplatin30-40mg/m2，iv. d1，2or carboplatin250-300mg/m2，iv. d1+paclitaxel75mg/m2，iv. d1). Results:1. Theshort term effective rates was77.28%in the concurrent chemoradiotherapy group and65.88%in the sequential chemoradiotherapy group, and there was no significantdifference（χ~2=1.089，P=0.295）；2.1,2,3-years survival rates of the two groups were77.91、61.18%，65.12%、47.06%and41.86%、31.76%respectively, and the statisticdifference was found between them (χ~2=5.098, P=0.024);3.1,2,3-years survival ratesof the Han and the Minority in the two groups were82.98%、71.95%，68.09%、61.54%，53.19%、28.21%and70.21%、50.00%，57.45%、34.21%，40.43%、21.05%respectively,which could be found that the survival rates of the Han were higher then the Minority,but the statistic difference can only be found in the sequential chemoradiotherapy group（χ~2=8.325，P=0.016）; It also could be found that the survival rates of the concurrentchemoradiotherapy group were higher then the sequential chemoradiotherapy group inboth Han group and the Minority group（χ~2=3.549，P=0.049andχ~2=3.955，P=0.039）. 4. The main toxicity of the two groups were radiation esophagitis, myelosuppression andgastrointestinal reaction, which were more serious in the concurrent chemoradiotherapygroup than the sequential chemoradiotherapy group, but only in the myelosuppressionand gastrointestinal reaction we can found the statistic difference (χ~2=12.74，P=0.013andχ~2=10.47，P=0.033), however all patients were well-tolerated. Conclusion: Theconcurrent chemoradiotherapy has higher survival rates compared with the sequentialchemoradiotherrapy for advanced esophageal carcinoma, the efficiency is different in thedifferent Peoples, and the toxicity are tolerable.