后程加速超分割放射治疗食管癌

Late Course Accelerated Hyperfractionation Radiotherapy for Esophageal Carcinoma

目的探讨后程加速超分割放射治疗食管癌的临床疗效。方法100例食管癌患者随机分为两组：常规照射组（A组）和后程加速超分割照射组（B组），每组50例。A组采用常规照射，2GY／d，5次／周，总剂量60GY，疗程6周；B组先常规照射30GY，加用后程加速超分割照射，1．5GY／次，2次／d，间隔6h以上，总剂量60GY，疗程5周。结果B组局控率92．00％（46／50），1～3年生存率分别为74．00％（37／50）、50．00％（25／50）、44．00％（22／50）；A组局控率84．00％（42／50），1～3年生存率分别为54．00％（27／50）、26．00％（13／50）、22．00％（11／50），两组1～3年生存率比较，均有显著性差异（P均〈0．05）；Ⅲ度放射性食道炎副反应率：A组为0．00％，B组为6．00％，两组比较，无显著性差异（P〉0．05）。结论后程加速超分割照射能明显提高食管癌患者的年生存率，且放疗毒副反应少。

Objective To evaluate the clinical efficacy of late course accelerated fractionation radiotherapy for esophageal carcinoma. Methods One hundred patients with carcinoma of thoracic esophagus were treated from September 1998 To February 2002, they were randomly divided into two groups. The conventional fraction radiation （CFR） group included 50 patients receiving routine radiotherapy（2GY per day 5 times a week to a total dose of 60GY in 6 weeks） ;while the late course hyperfraction radiation （LCHR） group patients were irradiated 2. 0GY per day, 5 times a week to a total dose of 30GY early course and then irradiated by 1.5GY per day,twice a day （at more than 6 hoursr interval） , to the total dose of 60GY in 5 weeks ; Results The local control rates were 92% in LCHR group and 84% in CFR group. There was not significant difference between them. The one-, two- and three-yearsr survival rates in the LCHR group were 74.00% （37/50）, 50. 00% （25/50）, 44. 00% （22/50）, respectively; and that in the CFR group 54.00% （27/50） ,26.00%（13/50） and 22.00% （11/50）, respectively,The survival rates in LCHR group were much better than those in CFR group （P〈0.05）. There were no significant differences of acute complications or specific sequelae between the two groups （P〉0.05）. Conclusion The results from this study show that the late course accelerated hyperfeactionation radiotherapy regimen could improve the survival rate of esophageal carcinoma without increasing any untoward radioreactions or complications.