食管癌后程加速超分割放疗加甘氨双唑钠增敏的临床研究

Clinic study of late accelerated hyperfractionated radiotherapy combined with CMNa for esophageal carcinoma

目的观察后程超分割放疗加甘氨双唑钠治疗食管癌的疗效。方法将151例食管癌患者随机分为3组：常规放疗组（A组）52例，照射剂量2．0Gy／次，5次／周，总量66～70Gy；后程超分割放疗组（B组）53例，先常规照射，照射剂量40Gy，20次后改为每日照射2次，1．3～1．5Gy／次，2次照射间隔4～6h，10次／周，超分割照射26～30Gy／20次，总量66～70Gy／6周；后程超分割放疗加甘氨双唑钠组（C组）46例，照射方法与B组相同，放疗开始就同时静滴甘氨双唑钠800mg／m2，每周3次，连续用药至放疗结束。结果A、B、C3组近期有效率分别为73％，87％和96％。部分缓解率和1a生存率分别为53％，48％；82％，73％；89％，86％。C组部分缓解率和1a生存率均优于A组和B组（P均〈0．01）。3组均未发现毒副作用。结论甘氨双唑钠对食管癌的放疗有增敏作用，同后程超分割放疗结合应用，能提高食管癌的部分缓解率和1a生存率。

Objective It is to observe the effect of late accelerated hyperfractionated radiotherapy combined with CMNa on esophageal carcinoma. Methods 151 case of patients with esophageal carcinoma were randomly divide into 3 groups： group A （52 cases） were given normal radiotherapy with the dose of 2.0 Gy every time, 5 times every week, total dose 66- 70 Gy; group B （53 cases） were first given 40 Gy of conventional radiotherapy, then were irradiated twice a day, 1,3-1.5 Gy every time and ten times every week, then given hyperfractionated radiotherapy 26 -30 Gy/20f, total dose 66 - 70 Gy/6 week; group C were added CMNa 800 mg/m^2 by intravenous drip three times a week on the basis treatment of group B, Resuits The rencent effective rate of group A, B, C were 73 %～87 % and 96 % respectively, the partial control rate and one year survival rate were separately 53 %, 48 % ; 82 %, 73 % ; 89 %, 86 %. The partial control rate and one year survival rate of group C were both higher than those in group A and group B （ P 〈 0,01 ）. No side effect was found in the three groups. Conclusion CMNa can strengthen the radiotherapy effect on esophagus carcinoma and can raise the partial control rate and one year survival rate combined with late accelerated hyperfractionated radiotherapy.