食管癌常规分割剂量每周5天与每周7天照射的疗效观察

Comparision between radiotherapy on esophageal cacinoma with conventional fraction dose 7-day-per week and 5-day-per-week.

目的 观察和比较常规分割剂量每周照射7天与每周照射5天两种方法治疗Ⅲ期食管癌的疗效及放射反应。方法 对96例Ⅲ期食管癌首治病例随机分成每周照射7天组（治疗组）和每周照射5天组（对照组），治疗组48例，2．0Gy／次，1次／天，7天／周，共60～70Gy，30～35分次，30～35天完成；对照组48例，2．0Gy/次，1次／天，5天／周，共60～70Gy，30—35分次，40～47天完成。结果 治疗组与对照组1、2、3年生存率分别为77．1％、62．5％、50％和66．7％、37．5％、22．9％，治疗组高于对照组（P〈0．05）。1、2、3年局控率分别为81．3％、64．6％、54．1％和68．7％、41．6％、31．2％，治疗组高于对照组（P〈0．05）。急性放射性食管炎发生率分别为10．4％和6．2％，差别无显著意义（P〉0．05）。出血穿孔的发生率分别为6．2％和4．3％，差别无显著意义（P〉0．05）。结论 常规分割剂量7天／周照射比5天／周照射可提高疗效，未明显增加不良反应。

Objective To evaluate the effect of radiotherapy on stage Ⅲ a esophageal cancer with conventional fraction dose 7 - day - per - week. Methods A total of 96 patients with stage Ⅲ a esophageal cancer were divided into 2 groups ： the 7 - day - per - week group （ 48 patients ） and the 5 - day - per - week group （ 48 patients）. Patients in the 7 - day - per - week group received a total dose of 60 - 70 GY/30 - 35fraction/30 - 35 days, and the 5 -day-per-week group received a total dose of 60 -70GY/30 -35 fraction/40 -47 days. Results The 1 - ,2 - ,3 - year survival rates of the 7 - day - per - week group and the 5 - day - per - week group were 77.1% ,62. 5% ,50% and 66.7% ,37.5% ,29.2% , （ P 〈0.05 ）. The 1 -, 2 - , 3 - year local tumor control rates of the two groups were 81.3% ,64.7% ,54.1 and 68.7% ,41.6% ,31.2%, （ P 〈0.05 ）. The aute esophigitis and massive hemorrhage of the two groups were 10.4%,6.2% and 6. 2% ,4. 3% （P〉0.05）.Conclusion The 7-day-per-week radiotherapy can improve the local tumor control rate and survival rate of stage Ⅲa esophageal cancer, but not additional side reaction.