加速超分割放疗配合甲氨蝶呤增敏治疗食管癌的临床研究

目的 探讨不均等加速放疗配合甲氨蝶呤增敏治疗食管鳞癌的治疗效果.方法 回顾分析48例确诊为食管鳞癌患者的随访资料.放疗方案:先设前后野照射DT40～44 Gy,后改为等中心照射缩野躲开脊髓加量24～28 Gy,具体分割方法 为:周一至周五上午,常规分割剂量(2 Gy)1次/d;周一、三、五下午,与上午放疗间隔＞6 h,分割剂量1.5 Gy.化疗方案:每周2次静脉推注甲氨蝶呤50 mg,共3周.结果 1、3、5年的局部控制率和生存率分别为:80.8%、54.9%、39.6%和71%、42.6%、30.7%.结论 不均等加速放疗配合甲氨蝶呤增敏治疗食管鳞癌的治疗方法 是可行的.

Objective To evaluate the curative effect of methotrexate and heterogeneous acceleratedhyperfraction radiotherapy for advanced cancer of esophagus.Methods 48 patients with advanced cancer of e-sophagus were analyzed.The patients were irradiated with anteroposterior(AP)and posteroanterior(PA)fields toa dose of40-44 Gy followed by a boostof24-28 Gy through oblique fields in order to escape the spinal cord.Ev-ery patients were irradiated by routine fraction(2Gy once daily,5 days per week), added by 4.5 Gy per week(1.5 Gyonce on Monday,Wednesday,Friday).In addition to the radiotherapy,all patients received three cyclesof methotrexate infusion,50 mg/d for2 consecutiveas one cycle in the first,second and third weeks.Loco-region-al control an overall survival rates were estimated by the Kaplan-Meier method.Results The 1-,3-and 5-yearsurvival rates of 71%,42.6%,30.7%.The 1-,3-and 5-year local regional control rates were 80.8%,54.9%,39.6%.The toxic and side effects were tolerable.Conclusion The therapy of methotrexate plus heterogeneousaccelerated hyperfraction radiotherapy for advanced cancer of esophagus is effective with well tolerated toxic andside effects.