不均等分割放射治疗食管癌的研究

目的 :探讨不均等分割与常规分割放射治疗食管癌 12 0例疗效。方法 :( 1)不均等放疗组 60例 ,周一上午胸前垂直野( A) 2 5 0 c Gy间隔 6h,胸背垂直野 ( B) 2 5 0 c Gy。周二～五 ,胸背二侧野 ( C、D)轮照 ,每天各 140 c Gy/次 ,周六周日休息两天后重复上周治疗。肿瘤量 5 3 0 0 c Gy/3 0次· 3 5天。改缩胸前侧野 ( E、F野 )照射方法同前 ,照射剂量 10 60 c Gy/6次。总肿瘤量为 63 60 c Gy/3 6次· 42天。 ( 2 )常规分割放疗组 60例 ,每周 5次 ,每日轮照一野 ,每野 2 0 0 c Gy,休息两天后依次轮照 ,肿瘤总量 660 0 c Gy/3 3次· 45天。结果 :1、2年生存率 :不均等组 71.7%及 5 0 .0 %,常规组 46.7%及 3 5 .0 %,两组比较差异有显著性 ( P<0 .0 5 )。近期疗效好转率 :不均等组95 .0 %,常规组 73 .3 %,两组比较差异有显著性 ( P<0 .0 5 ) ,临床症状改善率 :不均等组 88.4%,常规组 71.7%,两组比较差异有显著性 ( P<0 .0 1)。结论 :不均等分割放射治疗能显著提高食管癌 1、2年的生存率 ,病人能顺利完成疗程。

RESEARCH ON IRREGULAR FRACTIONATED IRRADIATION OF ESOPHAGUS CANCER

patients with esophageal cancer were treated by radiotherapy.Of them,60 were given irregular fractionated irradiation.They received 250 cGy through field A on Monday mornings,once six hours,and 250 cGy through field B.From Tuesday to Friday,an alternative irradiation took place through field C and D treatment was continued,the dose schedule was 5300 cGy,given 30 times for 35 days.The irradiation through field E and field F was the same as that through fields C and D.They were given a dose of 1060 cGy six times.The total dose was 6360 cGy given 36 times for 42 days.Forty of the 120 patients were the ones of control group,in whom conventional fractionation irradiation was carried out five times every week.An alternative irradiation through one field was performed every day,with a dose of 200 cGy for each one.After two days'rest,such in irradiation was repeated,the total dose was 6600 cGy given thirty-three times for 45 days.Result:The one and two year survival rate was 71.7%,45% in the irregular fractionation irradiation group,and 50% ,35% in the conventional group (P<0.05). The improvement rate of short-term curative effect was 95 percent in the irregular group, and 73.3 percent in the conventional group (P<0.05).The improvement rate of clinical symptoms was 88.4 percent in the irregular group,and 71.7 percent in the conventional one (P<0.05 in both groups).