高-低氧放疗与低氧放疗对食管癌疗效的对比研究

The Contrast of High-Low Oxygen Radiotherapy and Low Oxygen Radiotherapy in Patients with Esophageal Carcinoma

目的比较高-低氧放射治疗与低氧放射治疗食管癌的近远期疗效及毒副反应。方法将68例欲接受根治性放疗的食管癌患者随机分入高-低氧组和低氧组。所有患者均采用6 MV X线照射,DT 1.8～2.0 Gy/次,每周5次。高-低氧组在放疗时先后吸入高、低浓度氧,低氧组在放疗过程中吸入低浓度氧。观察两组患者的总有效率,1年、3年、5年生存率,放疗急性反应及晚期并发症。结果高-低氧组有效率高于低氧组(81.3%VS 54.5%,χ2=5.2976,P=0.0214),两组1年生存率无明显差异(71.9%VS 57.6%,χ2=1.4529,P=0.2281),但3年及5年生存率高-低氧组均高于低氧组(53.1%VS 27.3%,χ2=4.5241,P=0.0334;34.4%VS 12.1%,χ2=4.5324,P=0.0333)。两组的放疗急性反应及晚期并发症差异无统计学意义。结论高-低氧放射治疗食管癌在总有效率及3年、5年生存率方面均优于低氧放疗,放疗毒副反应无明显增加。

Objective To investigate the clinical effects and side effects of high-low oxygen radiotherapy and low oxygen radiotherapy in patients with esophageal carcinoma.Methods From May 2004 to January 2006,68 cases of esophageal carcinoma were randomly divided into high-low oxygen group and low oxygen group.Patients in the former received radiation with high-low oxygen inspiring,while those in the latter were given radiation with low concentration oxygen inspiring.Radiation was administered with 6 MV X-rays,1.8-2.0 Gy per day and five times per week in both groups.Overall remission rates,1-year survival rates,3-year survival rates,5-year survival rates,acute radiation reactions and late complications of two groups were observed.Results Overall remission rate of high-low oxygen group was higher than that of low oxygen group（81.3% VS 54.5%,χ2=5.2976,P=0.0214）,there was no obvious difference in 1-year survival rates of two groups（71.9% VS 57.6%,χ2=1.4529,P=0.2281）.But 3-year survival rates and 5-year survival rates of high-low oxygen group were higher than those of low oxygen group（53.1% VS 27.3%,χ2=4.5241,P=0.0334;34.4% VS 12.1%,χ2=4.5324,P=0.0333）.There was no obvious difference in acute reactions and late complications caused by radiation in two groups.Conclusion High-low oxygen radiotherapy was better than low oxygen radiotherapy for esophageal carcinoma in overall remission rates,3-year survival rates and 5-year survival rates,and its side-effects could be tolerated well.