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连续加速超分割放射治疗和后程加速超分割放射治疗食管癌近期疗效比较

Continuous accelerated hyperfractionated and late-course accelerated hyperfractionated radiotherapy for esophageal carcinoma
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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
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