食管癌超分割放疗与常规放疗生存率及影响

The survival rate and effect of esophageal hyperfractioned radiotherapy and conventional radiotherapy

目的:探讨食管癌患者单纯超分割放射治疗与常规放疗生存率及影响。方法:将65例食管鳞癌患者随机分成两组,常规放疗组39例,常规分割,5次/周,1次/d,2 Gy/次,总剂量为70 Gy/7周;超分割放疗组26例,5次/周,2次/d,1.3 Gy/次,2次治疗间隔6 h,总剂量为65 Gy/5周。全部病例均采用GWGP80型钴-60远距离治疗机体外照射。结果:常规放疗组和超分割放疗组的1、3年生存率分别为46.1%、20.5%和61.5%、42.3%。超分割放疗组明显优于常规放疗组,两组比较,差异有高度统计学意义(P<0.01)。病变长度3～5 cm、蕈伞型预后好。两组患者放疗副作用比较,差异无统计学意义(P>0.05)。结论:全程超分割放疗(5次/周,1.3 Gy/次,2次/d,间隔6 h,总剂量为65 Gy/5周)能明显提高食管癌患者的生存率。

Objective： To study the survival rate and effect of esophageal cancer patients treated by pure hyperfractioned radiotherapy and conventional radiotherapy. Methods： 65 eases of patients with esophageal squamous cell carcinoma were randomly divided into two groups, 39 cases of conventional radiotherapy using conventional fractionation 5 fractions per week, 1 fraction per day, 2 Gy per fraction to total dose 70 Gy on 7 weeks; hyperfractioned radiation therapy group 26 eas- es, 5 fractions per week, 2 fractions per day with 6 hours between two fractions, 1.3 Gy per fraction to total dose 65 Gy on 5 weeks. All cases were treated with external beam radiotherapy by GWGP80 Co-60 cobalt teletherapy machine. Results： 1-year and 3-years survival rat of conventional radiotherapy and hyperfractioned radiotherapy group were 46.1%, 20.5% and 61.5%, 42.3% separately. Hyperfractioned group was significantly batter than the conventional group, there were significant differences in the two groups （P〈0.01）. Lesion length of 3-5 cm of fungating tupe had a good prognosis. There was no significant difference of radiotherapy toxity between the two groups （P〉0.05）. Conclusion： Hyperfractioned radiation therapy （5 fractions per week, 1.3 Gy per fraction, 2 fractions per day with 6 hours interval to total dose 65 Gy over 5 weeks） could sificanfly improve the survival rate.