后程加速超分割照射加选择性化疗治疗食管癌的临床研究

THE STUDY OF PATIENTS WITH LATE ACCELERATED RADIATION AND CHOICE CHEMOTHERAPY FOR ESOPHAGEAL CARCINOMA

目的 :评价后程加速超分割放射治疗加选择性化疗对食管癌的长期疗效。方法 :自 1997年 5月至1999年 6月 ,对 80例食管鳞癌病人随机分为两组 :后超放疗组和后超放疗加选择性化疗组。后超放疗组 4 0例 ,每次 180～ 2 0 0 c Gy,每周 5次 ,共 30 0 0 c Gy/ 3周 ;第四周开始起每次 15 0 c Gy,每日 2次 ,间隔 6小时 ,照射量 30 0 0 c Gy/ 2周 ,总照射量 6 0 0 0 c Gy/ 5周。后超加选择性化疗组 4 0例 ,放疗方法同后超组 ,放疗完成后 ,休息 3周 ,选择病理为中低分化及明显外侵者行 CBP+ 5 - Fu化疗 3周期。结果 :3年局控率分别为 5 2 .5 %及 6 5 %。 1、2、3年生存率分别为 70 %、5 2 .5 %、4 0 %及 82 .5 %、6 7.5 %、5 7.5 %。结论 :后超加速照射加选择性化疗能进一步提高食管癌病人 1、2。

Objective:To evaluate the effect of late course accelerated radiation for esophagus carcinoma.Methods:80 patients with esophagus squamous cell carcinoma were treated from May 1997 to June 1999.They were randomly divided into two groups:late course hyperfraction radiation(LCHR)group(40 patients)and LCHR and choice chemotherapy(LCHR&CC)group(40 patients).Patients in LCHR received 180cGy to 200cGy/perday,5 times a week to a total dose of 3000c Gy in 3 weeks and then followed by accelerated fraction using reduced field 150cGy twice a day with 6 hour in terval and 3000cGy/2weeks,The total doses of 6000cGy/5 weeks .Patients of the poorly differentiated tumors given drug therapy (Caboplatin and 5 Fluorouracil)after finished LCHR.Results:The local control rates of three years were 52.5%in LCHR group and 65%in LCHR&CC group(P<0.01).The one、two and three years survival rates were 82.5%,67.5%and 57.5% in LCHR&CC group and 70%,52.5%,40%ih LCHR group(P<0.01).Conclusion:The survival rates of patients with esophageals carcinoma can be futher improved by LCHR&CCwithout increasing any complication.