摘要
目的比较单纯后程加速超分割放射治疗及后程加速超分割放射治疗辅加化疗治疗食管癌的疗效与毒副反应。方法将162例食管癌患者随机分为2个组:①后程加速超分割放疗组(简称单放组,LCAFR),80例。治疗方案:常规分割30 Gy+加速超分割(1.5 Gy/次,2次/天,间隔≥6 h),总剂量为63 Gy;②后程加速超分割放疗辅加化疗组(简称综合组,LCAFR+C),82例。治疗方案:在后程加速超分割放疗(LCAFR)的同期加用顺铂(DDP)20 mg、氟脲嘧啶(5-Fu)500 mg、亚叶酸钙(CF)0.2 g,连用5天为1个周期,分别在第1、4周实施,共2个周期。结果单放组和综合组的1、2、3年生存率分别为53.8%(43/80)、35.0%(28/80)、25.0%(20/80)和79.3%(65/82)、54.8%(45/82)、43.9%(36/82),2组有显著性差异(χ2=10.33,P<0.01;χ2=5.61,P<0.05;χ2=5.65,P<0.05)。2组患者的死亡原因均以肿瘤局部未控制和复发为主。综合组因肿瘤局部未控制和复发的死亡率(50.0%,18/36)明显低于单放组(75.0%,45/60),2组比较有显著性差异(χ2=6.18,P<0.05)。2组治疗的急性毒副反应以消化系统及造血系统毒副反应为主,综合组急性毒副反应发生率Ⅲ度消化系统为(18.3%,15/82)高于单放组,但无显著性差异。结论后程加速超分割放射治疗辅加化疗能显著提高食管癌患者的3年生存率,虽毒性增加但可以耐受。
Objective To compare the treatment effects and toxicity of late course accelerated hyper fractionation radiotherapy(LCAFR), LCAFR plus concurrent chemotherapy(LCAFR + C) on esophageal cancer. Methods 162 patients of esophageal carcinoma were randomly divided into two groups, in the LCAFR group,80 patients first recevied 30 Gy by routine fractionation, followed by 33 Gy, 1.5 Gy twice daily,at more than 6 hours' interval, 5 days per week, total doses were 63 Gy. In the combined group, 82 patients receive two cycle dayly. Curing formulas were 20 mg DDP and 500 mg 5-Fu plus 0.2 CF for five consecutive days as one cycle in the first and fourth weeks. Results The 1-,2-,3-year survival rates of the combined and LCAFR groups were 79.3%, 54.8 %, 43.9 % and 53.8 %, 35.0 %, 25.0 % (X^2 = 10.33, P 〈 0.01 ;X^2 = 5.61, P 〈 0.05;X^2 = 5.65, P 〈 0.05). Threr were statistical significance in the two groups, The main death cause of two groups was local recurrence and uncontrolled of tumor. The LCAFR + C group was lower(50.0%, 18/36) than the LCAFR groups(75,0% ,45/60). There was statistical significance in the two groups(X^2= 6.18, P 〈 0.05). The acute toxic effect was severer in the LCAFR + C group than in the LCAFR group in Ⅲ degree digestive system and hematopoietic system. There were no significant differences in the two groups. Conclusion The esophagus carcinoma patients's survial rate of LCAFR + C group was significant higher than the LCAFR group. Toxicity of patient was increasing but the patients could tolleats.
出处
《实用癌症杂志》
2005年第4期407-409,共3页
The Practical Journal of Cancer
关键词
食管癌
放射疗法
后程加速超分割
化学疗法
预后
Esophageal carcinoma
Radiotherapy
Late course accelerated hyperfractionation(LCAFR)
Chemotherapy
Prognosis