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食管癌后程加速超分割三维适形放疗同步化疗的临床研究 被引量:1

The Clinical Study of Esophageal Carcinoma with the Three Dimensional Conformal Late Course Accelerated Hyperfraction Radiotrerapy Plus Concurrent Chemtherapy
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摘要 目的:评价单纯后程加速超分割三维适形放疗与后程加速超分割三维适形放疗同步化疗的近期疗效、1年局控率、1年生存率。方法:将2005年6月~2007年12月收集的58例完成治疗的符合纳入条件的食管癌患者。采用随机分组法将研究对象分为两组:单纯后程加速超分割三维适形放疗(late course accelerated hyperfraction radiotherapy,LCAHR),简称单放组;后程加速超分割三维适形放疗同步化疗组(late course accelerated hyperfraction radiotherapy plus concurrent chemotherapy。LCAHR+C),简称综合组。单放组先采用常规分割三维适形放疗,2.0Gy/f,1f/d,5f/周,40Gy/20f后,改为1.5Gy/f,2f/d,两次照射间隔时间≥6h,总剂量达67~70Gy/38~40f。综合组放疗方法同单放组,化疗采用DF方案,从放疗开始之日起,DDP 20mg,1~5d,静脉注射;5-FU:500mg,1~5d,静脉注射;CF:200mg,1~5d,静脉注射,28d为1个周期,连用5个周期。观察指标主要包括近期疗效、1年局控率、1年生存率。结果:综合组和单放组的近期疗效分别为93.1%和69%(Х^2=5.14P〈0.05);1年局控率分别为86.2%和65.5%(Х^2=4.84P〈0.05);1年生存率分别为89.6%和65.5%(Х^2=4.84P〈0.05)。综合组的近期疗效、1年局控率、1年生存率均高于单放组,差异有显著性意义。结论:食管癌后程加速超分割三维适形放疗同步化疗可以提高近期疗效、1年局控率及1年生存率,远期疗效值得进一步探讨和研究。 Objective: To evaluate and compare the shortterm effect, one- year local control rate, oneyear survival rate. Method: From June 2005 to March 2007, 58 patients with pathologically confirmed esophageal carcinoma were randomly divided into two groups, with 29 patients in each arm: Three dimensional conformal late course accelerated hyperfraction radiotherapy group (LCAHR) and three dimensional conformal late course accelerated hyperfraction radiotherapy plus concurrent chemotherapy group (LCAHR + C) .The schedule of LCAHR was as following: conventional radiotherapy of 2.0 Gy per day, once per day, five days per week, was treated during the first phase to a total dose of 40 Gy, then followed by LCAHR( twice per day, 1.5 Gy per fraction, interval between two fractions more than six hours, to the total dose of 67-70 Gy with 38-40 fractions). The LCAHR + C was accepted the same radiotherapy technique as the LCAHR. The chemotherapy regimen: DDP 20 mg, 1- 5 d, injection; 5 - FU 500 mg, 1- 5 d, injection; CF 200 nag, 1- 5 d, injection, 28 days in one cycle to total five cycles. The radiotherapy and chemotherapy were used simultaneously. The ex- amined indexes included the short- term effect, one- year local control rate, one- year survival rate. Results: The LCAHR+ C and the LCAHR in the short- term effect were 93.1% and 69%( Х^2 = 5.14 P〈0.05) respectively; the one - year local contral rates were 86.2 % and 65.5 % respectively ( Х^2 = 4.84 P 〈 0.05) ; the one - year survival rates were 89.6 % and 65.5 % respectively ( ;z = 4.84 P 〈 0.05). The LCAHR + C was superior to the LCAHR in the short - term effect, one - year local control rate and one- year survival. Conclusion: LCAHR + C can significantly improve the short - term effect, one - year local control rate and one - year survival. But the toxicity in digestive and hematopoietic system were increased. Longterm treatment effect is worth the further study.
出处 《内蒙古医学杂志》 2008年第12期1418-1422,共5页 Inner Mongolia Medical Journal
关键词 食管癌 三维适形放疗 同步放化疗 临床疗效 Esophageal carcinoma Three dimensional conformal radiotherapy Concurrent chemoradiotherapy Clinical efficiency
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