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食管癌全程连续后程加速超分割放疗的临床研究 被引量:15

Clinical Efficacy of Radiotherapy on Esophageal Cancer with Conventional Fraction Dose 5-day-per-week and 7-day-per-week and Late Course Accelerated Hyperfraction.
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摘要 目的 观察和比较常规分割剂量每周照射5天、7天且后程加速超分割2种方法治疗Ⅲ期食管癌的疗效及放射反应。方法 对92例Ⅲ期食管癌首治病例随机分成每周照射5天组(A组)、每周照射7天且后程加速超分割组(B组)。A组46例,2.0Gy/次,1;L/天,5天/周,共60~70Gy,40~47天完成;B组46例,2.0Gy/次,1;L/天,7天/周,DT40Gy/20天后,改为每次1.2Gy,每天2次,间隔6小时以上共60~70Gy,30~35天完成。结果A组、B组的1年生存率分别为32.6%、67.4%;3年生存率分别为6,5%、43.5%。B组高于A组(P〈0.05)。1年局部控制率分别为34.8%、71.7%;3年局部控制率分别为17.4%、56.5%,B组高于A组(P〈0,05)。A组和B组Ⅱ级及以上急性放射性食管炎发生率分别为13.0%、47.8%,B、组高于A组(P〈0.05)。出血穿孔的发生率分别为4.3%、6,2%,两组无显著差异(P〉0.05)。结论 常规分割剂量7天/周照射且后程加速超分割照射比5天/周照射可明显提高疗效.除了Ⅱ级及以上急性放射性食管炎发生率明显增高外,其他不良反应无显著增加。 Objective To evaluate the effect of radiotherapy on stage Ⅱ -Ⅲ esophageal cancer with conventional fraction dose 5-day-per-week and 7-day-per-week and late course accelerated hypeffraetion. Methods From Feb. 1999 to Jun. 2002 92 patients with stage Ⅱ -ⅢI esophageal cancer were divided into 2 groups: the 5-day-per-week group (group A,46 patients) and the 7-day-per-week group and late course accelerated hyperfraction group (group B,46 patients). Patients in the A group received a total dose of 60 - 70 Gy/30 - 35 fraction/40 - 47 days, and the B group received a total dose of 60 - 70 Gy/30 - 35 fraction/30 - 35 days. Results The 1 -year survival rates of the group A and B were 32.6% ,67.4% ( P 〈 0.05 ). The 1 - year local tumor control rates of the two groups were 34.8% -71.7% ( P 〈 0.05 ). The 3-year survival rates of the group A and B were 6.5 % ,43.5 % ( P 〈 0.05 ). The 3- year local tumor control rates of the two groups were 17.4% ,56.5 % ( P 〈 0.05 ). Stage Ⅱ-Ⅳ IWof the aute esophigitis massive hemorrhage of the two group were 13.0% ,47.8% (P 〈0.05). The massive hemorrhage of the two groups were 4.2% ,6.3% ( P 〉 0.05). Conclusion The 7 - day- per - week and the late course accelerated hyperfraetion radiotherapy can improve the local tumor control rate and survival rate of stage Ⅲ esophageal cancer. Radiation - induced esophigiris is more common in the accelerated hyperfraetion group.
出处 《实用癌症杂志》 2007年第1期88-90,共3页 The Practical Journal of Cancer
关键词 食管肿瘤 照射疗法 放射剂量分次 预后 Esophageal neoplasms Radiothaeapy Dose fraetionation Prognosis
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