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食管癌后程加速超分割放疗协同化疗的疗效评价 被引量:23

Evaluation of late course accelerated hyperfractionated radiotherapy plus concurrent chemotherapy for esophageal carcinoma
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摘要 目的 评价后程加速超分割放疗协同化疗食管癌的疗效和副反应。方法 对173例食管鳞癌患者进行前瞻随机分组研究,其中后程加速超分割放疗(LCAHR)组89例,后程加速超分割放疗协同化疗(LCAHR+C)组94例。LCAFR组前2/3疗程常规分割放疗至40Gy(1.8~2.0Gy/次,1次/d,5d/周),后1/3疗程缩野后改用后程加速超分割(1.5Gy/次,2次/d,5d/周),全程总剂量60~70Gv,34~42分次,37。42d完成。LCAFR+C组在上述放疗的同时加用化疗,从放疗第1天给予LFP方案:顺铂(PDD)20mg/d,亚叶酸钙(CF)100mg/d,氟尿嘧啶(5-Fu)500mg/d,均连续静脉滴注5d,28d为1个周期,共4个周期。结果 LCAHR组和IEAHR+C组近期总有效率分别为85%和95%(X^2=4.45,P=0.035);1、2、3年局部控制率分别为73%、55%、49%和83%、73%、65%(X^2=5.32,P=0.021);1、2.3年生存率分别为74%、53%、41%和84%、65%、52%(X^2=2.85,P=0.091)。LCAHR+C组白细胞减少和消化道反应均明显高于LCAHR组(X^2=7.85、15.06;P=0.005、0.000)。结论 后程加速超分割放疗协同化疗可提高近期疗效和3年局部控制率,可作为食管癌较有效的治疗手段,但白细胞减少和胃肠反应毒副反应增加。 Objective To evaluate the treannent results and side-reactions of esophageal carcinoma treated with late course accelerated hypeffration radiotherapy plus concurrent chemotherapy(IEAHR + C). Me,otis A prospective randomized trial was carried out on 173 esophagus squamous carcinoma patients whom were randomized into two groups: 1. LCAHR group--89 patients treated by conventional fractionated radiotherapy during the first two-thirds of the whole course with 40 Gy in 20-22 fractions, then followed by LCAHR with 20-30 Gy in 14-20 fractions, 1.5 Gy per fraction, 2 times per day, to a total dose of 60-70 Gy in 34-42 fractions over 37-42 days; 2. LCAHR + C group--94 patients were received the same radiotherapy as LCAHR, supplement with concurrent chemotherapy from the first day of radiotherapy. The chemotherapy regimen was LFP: intravenous infusion of cisplatin 20 mg/d, calcium folinate 100 mg/d and 5-fluorouraci1500 mg/d for five consecutive days, every 28d as one cycle to totaUy 4 cycles. Results The short-term effective rate was 85% and 95% in LCAHR and LCAHR+C group, respectively(X^2 = 4.45, P = 0. 035). The 1-, 2-and 3-year local control rate was 73 %, 55 %, 49% and 83 %, 73 %, 65 % in LCAHR and LCAHR + C gr %,41% and 84%, 65 %, 52% in LCAHRoup, respectively(X^2 = 5.32, P = 0.021 ). The 1-, 2- and 3-year survival rate was 74 %, 53 and LCAHR + C group, respectively (X^2 = 2.85, P = 0.091 ). The leucocytopenia and gastrointestinal tract side-reactions in IEAHR + C group were more severe than those ofLCAHR group(X^2=7.85,15.06;P=0.005,0.000). Conclusions Late course accelerated hyperfractionated radiotherapy plus concurrent chemotherapy can be taken as a effective treatment for esophageal carcinoma. It can improve short-term curative effect and local control rate, in spite of increase in leucocytopenia and aastrointestinal tract side-reactions.
出处 《中华放射肿瘤学杂志》 CSCD 北大核心 2006年第2期89-92,共4页 Chinese Journal of Radiation Oncology
关键词 食管肿瘤/放射疗法 食管肿瘤/化学疗法 放射剂量分次 预后 Esophageal neoplasms/radiotherapy Esophageal neoplasms/chemotherapy Dosage fractionafion Prognosis
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