后程加速超分割放射治疗中胸段食管癌的长期疗效

Long Term Results of Late Course Accelerated Hyperfactionation Radiotherapy for Middle Esphageal Carcinoma

目的 探讨后程加速超分割放射治疗中胸段食管癌的疗效。方法 78例中胸段食管鳞癌随机分为后程加速超分割组(LCAF) 3 9例 ,常规治疗组 (CF) 3 9例 ,两组患者一般临床资料差异无统计学意义。放射总剂量 :CF组 68Gy 3 4次 ,45～ 5 4d ,LCAF组68Gy 41次 ,44～ 46d。所有病例均采用6 0 Co远距离照射。结果 5年生存率和原发肿瘤局控率 ,与CF组比较 ,LCAF组明显提高。分别为 3 0 8%比 12 8%和 5 3 8%比 2 5 6%。LCAF组急性放射反应明显高于常规分割组 ,但患者能耐受 ,后期损伤两组无明显差别。结论 ①后程加速超分割放射治疗能为患者接受。

Objective To evaluate of late course accelerated hyperfactionation could improve the treatemt of middle esophageal carinoma.Methods From May,1988 to May,1995,78 patients with middle esophageal carcinoma were randomly divided into two groups. late course accelerated hypefactionation radiotherapeutic(LCAF)group (39 cases) and conventional factionation (CF) group (39 cases).There was no sinificant difference about clinical characteristics between the two groups.Total dose of 68 Gy/34 fx/45～54 days was given to CF group and that of 68Gy/41 fx/44～46 days to LCAF groups.The same cobalt 60 radiotherapy was used in both groups.Results The 5-year actual survival and local tumor control rates in the LCAF group were significantly improved when compared with CF group,being 30.8% vs 12.8%,and 53.8% vs 25.6% respectively.The acute reactions were increased but acceptable in the LCAF patients.The late reactions as observed were not increased in comparison with the CF patients.Conclusions ①LCAF can be tolerated by most patients with esophageal carcinoma.②LCAF gives better survival and local control rates.