食管癌全程加速超分割与后程加速超分割临床探讨

Clinical Investigation on the Effect and Complication of Post Period Accelerated Hyper-fractionation and Continously Accelerated Hyper-fractionation for Patients with Esophageal Carcinoma

目的:探讨食管癌全程加速超分割与后程加速超分割放射治疗的疗效。毒副作用及并发症。方法:将30例患者随机分为两组。第1组全程加速超分割放射治疗组(A组),第2组后程加速超分割放射治疗组(B组)。A组每天照射2次,每次1.5GY,2次间隔时间大于6小时,总剂量54GY/3.5W。B组前3周每天常规照射每次2 GY,每天1次。30GY以后加速超分割,每天2次,每次1.5GY,两次间隔大约6小时,DT:58.5GY/4.5W。结果:A、B两组均顺利完成疗程。疗效,A组CR:5例,PR:10例;B组,CR:4例,PR:10例,NC:1例。A、B两组疗效无明显差异。毒副反应主要表现为放射性食管炎,放射性气管炎,但无统计学意义,并发展早期食管穿孔,出血为主要表现。晚期以食管缩容,持续性咳嗽。两组无统计学意义。结论:两组均能耐受根治性放疗。A组急性反应较B组明显,但两组无统计学意义。

Objective:To investigate the result,toxic effect and complication of continuously accelerated hyper-fractionation radiotherapy and post period accelerated hyperfractionation for patients with esophageal carcinoma.Method: 30 cases with esophageal carcinoma were enrolled in the study.they.were divided into two groups by stratified randomization as follow a) the patient received continously accelerated hyper-fractionation 1.5GY/f,2fx/d.and b) those in the group of post period accelerated fractionation radiotherapy received the conventional fractionation 2GY/f,1fx/d,untill 3 weeks the total cobalt 30Gy radiotherapy was used.these patients received accelerated hyper fractionation 58.5GY/4.5W.Result:The radiation treatment were able to be complicated without any break.there was no signifciant difference in(a) and(b) group.The toxic effects were mainly radiation esophagitis and radiation tracheitis,but there was an significant difference.The early complications were mainly esophageal bleeding and esophageal fistula.and the later complication were mainly esophageal stenosis, haemoptysis and continuous cough,but there was no significant difference too.Conclusions: a) can be tolerated by most patients with esophageal carcinoma;the toxic effect and complication of gromp A are more severe than that of b).but there is no significiant difference.