摘要
目的 比较食管癌连续加速超分割 (CAHF)放射治疗和后程加速超分割 (LCAF)放射治疗的近期疗效和急性放射性毒副作用。方法 2 0 0 1年 1月至 2 0 0 4年 1月 ,我科共收治符合入组条件的食管癌患者 12 5例 ,并将其随机分为CAHF组和LCAF组。CAHF组采用全程加速超分割放射治疗 ,即 2次 d ,1.5Gy 次 ,至总量 6 0 .0Gy 4 0次 2 6~ 2 8d。LCAF组首先采用常规分割放射治疗 ,即 1次 d ,2 .0Gy 次 ,照射 4 0 .0Gy 2 0次 2 6~ 2 8d ,然后改用加速超分割治疗 ,2次 d ,1.5Gy 次 ,至总量 6 7.0Gy 38次 39~ 4 1d。结果 CAHF和LCAF组的Ⅲ +Ⅳ度放射性食管炎的发生率分别为 5 9.7%和 19.0 % (P <0 .0 5 ) ;放射性气管炎的发生率分别为 91.9%和 5 4 .0 % (P <0 .0 5 )。CAHF与LCAH组的局部控制率分别为 90 .3% (5 6 6 2 )和 93.7% (5 9 6 3) (P >0 .0 5 ) ;1、2、3年生存率分别为 6 8 5 %、5 5 .1%、4 8.9%和 6 8.6 %、4 9.9%、4 3.7% (P >0 .0 5 )。结论 CAHF与LCAF治疗食管癌的近期疗效相仿。但在CAHF组 ,Ⅲ、Ⅳ度急性放射性食管炎明显增多 ,反应高峰时间提前至放射治疗开始后第 3周 ;LCAF方案Ⅲ、Ⅳ度食管炎较少 ,以Ⅰ度和Ⅱ度反应居多 ,反应高峰期多在放疗即将结束时或放疗结束后。
Objective To compare the early results and acute side effects of continuous accelerated hyperfractionated (CAHF) radiotherapy and late-course accelerated hyperfractionated (LCAF) radiotherapy for esophageal carcinoma.?Methods From Jun. 2001 to Jun. 2004, 125 patients with esophageal carcinoma were randomized into two groups: 62 entered the CAHF and 63 entered the LCAF group. Patients in CAHF group were given continuous accelerated fractionated irradiation from the beginning of the treatment, that is: 1.5 Gy per fraction,twice a day, 5 days per week, to a total dose of 60 Gy/40 f/26~28 d. The LCAF group were given conventional fractions in the first part of the treatment to a dose of 40 Gy/20 f/26~28 d, followed by accelerated fractionated irradiation using reduced fields, twice daily at 1.5 Gy per fraction, to the total dose of 67 Gy/38 f/39~41 d. The interval between fractions was longer than 6 hours.?Results In CAHF and LCAF groups, the rates of acute esophagitis grade Ⅲ and Ⅳ were 59.7% and 19.0% respectively (P<0.05). The acute tracheitis rates were 91.9% and 54.0% respectively (P<0.05). The local control rates in CAHF and LCAF groups were 90.3%(56/62)and 93.7%(59/63) respectively(P>0.05). The survival rates at 1-, 2- and 3-years were 68.5%, 55.1% and 48.9% in CAHF and 68.6%, 49.9% and 43.7% in LCAF group (P>0.05).?Conclusions Both CAHF and LCAF radiotherapies are superior to the conventional regimen for esophageal carcinoma. CAHF and LCAF provide comparable local control rates and 1-, 2-, 3-year survival rates.
出处
《徐州医学院学报》
CAS
2004年第5期432-434,共3页
Acta Academiae Medicinae Xuzhou
关键词
连续加速超分割
放射治疗
后程加速超分割
食管癌
放射性食管炎
esophageal carcinoma
continuous accelerated hyperfractionated radiotherapy
late-course accelerated hyperfractionated radiotherapy
side effect