顺铂加后程加速超分割放射治疗食管癌临床研究

Clinical Study of Cisplatin Combined with Late-course Accelerated Hyperfractionated Radiotherapy for Esophageal Carcinoma

目的 :评价顺铂加后程加速超分割放射治疗食管癌的疗效。方法 :2 84例食道癌患者 ,随机分 2组(化放组与单放组 ) ,每组 14 2例。放疗采用 6MVX线外照 ,前 2 / 3疗程常规放射治疗 2Gy/次 ,共 4 0Gy;后 1/ 3疗程改用加速超分割放射治疗 (2次 /天 ,1 5Gy/次 ,间隔 6h ,共 9个治疗日照射 2 7Gy,合计总剂量 6 7Gy;化疗采用顺铂 2 0mg静脉滴注dl- 5 )结果 :化放组与单放组的 1、 2年生存率分别为 86 6 %、 70 4 %和 73 2 %、 5 0 7%(P <0 0 5 ) ;3、 4年生存率分别为 4 8 5 %、 4 1 5 %和 4 0 8%、 34 5 % (P >0 0 5 )。结论 :顺铂加后程加速超分割放射治疗食管癌能提高患者近期生存率 。

Objective:To evaluate the efficacy of cisplatin combined with late-course accelerated hyperfractionated radiotherapy for esophageal carcinoma.Method:Two-hundred and eight-four cases with esophageal carcinomas were randomized into two groups(the chemoradiotherapy group and radiotherapy alone group).Each group consists 142 cases.6MVX-ray was employed externally.Conventional radiotherapy of 2Gy per day was employed during the former two thirds course to a total dose of 40Gy,then followed by accelerated hyperfractionated(twice per day,1.5Gy at one time,6-hour interval,27Gy for 9 days,a total dose of 67Gy,20mg cisplatin ivgtt used from dl to d5).Results:1-and 2-year survival rate in the combined group and the single group were 86.6%,70.4% and 73.2%,50.7% respectively(P<0.05),and 3-and 4-year survival rate were 48.5%,41.5% and 40.8%,34.5% respectively(P>0.05).Conclusions:Cisplatin plus late-course accelerated hyperfractionated radiotherapy for esophageal carcinoma could possiblly improve the short term survival rate with well tolerated side effects.