后程加速超分割三维适形放疗治疗食管癌的疗效分析

Clinical efficacy of late course accelerated hyperfractionation radiotherapy plus three dimensional conformal radiotherapy on patients with esophageal carcinoma

目的探讨后程加速超分割三维适形放疗治疗食管癌的疗效和不良反应。方法将110例食管癌患者随机分为后程加速超分割三维适形放疗组(试验组)和单纯三维适形放疗组(对照组),每组55例,均采用6MV X线外照射。试验组患者前2/3疗程采用三维适形放疗,总剂量38Gy分19次,后1/3疗程采用后程加速超分割三维适形放疗,每次1.4 Gy,每天2次,间隔6h以上,补量总剂量28Gy,至总剂量66Gy结束疗程。对照组采用单纯三维适形放疗,总剂量66Gy分33次。比较两组患者的治疗效果。结果试验组患者的1年、3年和5年生存率分别为78.2%、52.7%和32.7%,对照组患者分别为69.1%、43.6%和25.5%,两组差异无统计学意义(P>0.05)。结论后程加速超分割三维适形放射治疗食管癌具有提高生存率的趋势。

Objective To analyze the clinical efficacy of late course accelerated hyperfractionation radiotherapy（ LAHR） plus three dimensional conformal radiotherapy（ 3DCRT） on patients with esophageal carcinoma. Methods 110 patients with esophageal carcinoma were randomly divided into the experimental group（ 55 cases,treated with LCAH and 3DCRT） and the control group（ 55 cases,treated with 3DCRT）. All patients were given X-ray of 6MV. The experiment group treated with conventional fractionation radiotherapy in the first two-thirds of the course with a total dose of 38 Gy /19 f,and then followed by LCAHR plus3 DCRT,1. 4Gy per fraction,twice daily,with a total dose varied up to DT66 Gy. The control group received3 DCRT and the total dose varied up to DT66 Gy /33 f. Results The 1-year,3-year and 5-year survival rate of the experimental group were 78. 2%,52. 7% and 32. 7%,respectively,and were 69. 1%,43. 6% and25. 5% in the control group,respectively（ P〉0. 05）. Conclusion LCAHR and 3DCRT has the trend to improve the survival rate of patients with esophageal carcinoma.