后程加速超分割放射治疗加化疗治疗食管癌的临床研究

Study of the Course Accelerated Hyper-Fractionation Radiotherapy plus Chemotherapy for Esophageal Carcinoma

目的 探讨后程加速分割放射治疗同时化疗对食管癌的治疗价值。方法 按入选条件分为两组 ,后程加速分割放射治疗同时化疗的 5 0例病人为综合组 ,同期单纯后程加速超分割放射治疗的 46例病人为后超组。均采用60 Co放疗 ,一前垂直及两后斜野 ,前 2 / 3剂量常规分割放疗 ,到DT 40Gy后 ,改后程加速超分割放射治疗 ,综和组在放疗第一周同时化疗 ,采用顺铂 +5 Fu方案。结果 综合组 2、3年生存率 60 %、5 2 % ,后超组 2、3年生存率 41 3 %、3 0 4% ,两组生存率差异有显著性意义 (P <0 0 5 )。两组主要死亡原因局部未控或复发 ,分别为 65 %、85 8% ,两组差异有显著性意义 ( χ2 =5 92 ,P <0 0 5 )。两组远地转移分别为 18 3 %和14 2 % ,两组差异无显著性意义 ( χ2 =1 45 ,P >0 0 5 )。两组血液毒副反应相似 ,均能耐受。结论 以顺铂、5 Fu为主联合化疗加后程加速分割放射治疗食管癌 ,提高了生存率、局部控制率 ,降低了复发率 ,毒副反应可以耐受。

Objective To study the therapeutic effect of late coure accelerated hyper-fractionation radiotherapy (LCAHR) plus chemotherapy for esophageal carcinoma.Methods 50 patients treated by LCAHR plus chemotherapy for esophageal carcinoma (R+C) and 46 patients treated by LCAHR alone(R). 60 Co was used for all patients.40 Gy was given to all patients with conventional fractionation regiment followed by LCAHR with reduced fields.The total dose was 60～70 Gy.The R+C group received chemotherapy with DDP+5-Fu regimen at the beginning of RT.Results The two and three-year survival rates were 60%,50% in R+C group and 41.3%,30.4% in R group,respectively.The survival rates in R+C group were significantly better than those in R group (P<0.05).The incidences of local recurrence in the two group were 65% and 85.8% respectively (P>0.05).But the distant metastasis rates were 18.3% and 14.2% respectively(P>0.05).Conclusion Inductive LCAHR plus chemotherapy for esophageal carcinoma can gain good effect and is worth further studying.