后程加速超分割适形放疗联合回生口服液治疗食道癌的疗效分析

Late Course Accelerated Hyperfractionation Conform Radiotherapy Concomitant with Huisheng Koufuye in Patients with Esophageal Carcinoma

目的：评价后程加速超分割联合回生口服液治疗食道癌及其副反应。方法：对68例食道癌随机分为后程加速超分割适形放疗联合组（后程加速超分割适形放疗联合回生口服液组）和常规适形放疗组，每组34例，全部经病理证实。全部采用10Mv的X线外照射，常规适形放疗组1次/日，2Gy/次，总剂量64-68Gy/6-7W，后程加速超分割适形放疗联合回生口服液组在照射44Gy后，每日2次，每次剂量为1.5Gy,两次放疗之间间隔6小时，总剂量为65-68Gy/5-6W.放疗开始即口服回生口服液，每次1支（10ml），一日三次，至放疗结束后4周。结果：1、3年局控率后程加速超分割适形放疗联合咽生口服液组为82.4%、61.8%，常规组为41.2%、29.4%.后程加速超分割适形放疗联合回生口服液组1、3年生存率分别为73.5%、41.2%，常规组为44.1%、23.5%（P〈0.05）。后程加速超分割适形放疗联合回生口服液组较常规组放射性食道炎低，分别为20.6%和38.2%（P〈0.05），余副反应两组之间均无明显差异（P〉0.05）。结论：食道癌后程加速超分割适形放疗联合回生口服液组能提高食道癌的治疗效果，患者对后程加速超分割适形放疗联合回生口服液组的耐受性可。

Objective： To evaluate the efficacy of late course accelerated hypeffractionation conform radiotherapy concurrent Huisheng koufuye in the patients with carcinoma of the oesophagus. Methods： Sixty - eight patients with histologically confirmed carcinoma of the esophagus were randomized into two groups. （ 1 ） The conventional conform radiotherapy group received 2.0Gy per day, five times a week, to a total dose of 64 - 68Gy in 6 - 7weeks, and {2} Late course accelerated hyperfractionation conform radiotherapy concomitant with Huisheng koufuye group which received the same schedule as the CF group during the in＇st two thirds of the course of radiotherapy to a dose of 44Gy/4- 5w. This was then followed by accelerated hyperfractionation using reduced fields. In the LCAF portion of the radiotherapeutic course, the irradiation schedule was changed to 1.5 Gy twice a day, with an interval of 6 h between fractions, to a dose of 65 - 68Gy/5 - 6w. Huisheng koufuye 10ml tid orally was administered on day 1 of radiotherapy until 4 weeks after radiotherapy finished. Results： The 1, 3 year of local control in LACF plus Huisheng koufuye were 82.4%, 61.8% and 41.2%, 29.4% in the conventional conform radiotherapy group { P 〈 0.05}. The 1, 3 years of survival rates in the LACF plus Huisheng koufuye group were 73.5%, 41.2%, and 44.1%, 23.5%, respectively in the conventional conform radiotherapy group { P 〈 0.05 ）. The radiation esophagitis in the LACF plus Hnisheng koufuye group was lower （20.6%vs38.2% ） in comparison with that of the conventional conform radiotherapy group. Conclusion： The results from this study showed that the late course accelerated hyperfractionated radiotherapy concomitant with Hnisheng Koufuye can improve the treatment effects in esophageal carcinoma { P 〈 0.05 }, with acceptable acute toxcities as compared to conventional radiotherapy.