98例食管癌加速超分割放疗的临床研究

目的：评价加速超分割放射治疗食管癌的疗效。方法：从１９９０年１０月至１９９２年５月我们对９８例经病理证实为食管鳞癌的患者进行了研究。随机分为常规组和加速超分割组。常规组：１８０～２００ｃＧｙ／次，５次／周，总量６０００～７０００ｃＧｙ／６～７周；加速超分割组：１５０ｃＧｙ／次，２次／日，间隔６小时以上，总量５４００ｃＧｙ／３．５周。两组患者均采用６０Ｃｏ远距离外照射。结果：常规组１，３，５年生存率分别为４６％（２３／５０）、２０％（１０／５０）、１２％（６／５０）；加速超分割组１，３，５年生存率分别为７０．８％（３４／４８）、３９．６％（１９／４８）、２９．２％（１４／４８），加速超分割组明显优于常规组（Ｐ＜０．０５），而两组放疗反应和并发症无明显差异。结论：我们的初步研究显示：加速超分割放疗能明显提高食管癌患者的生存率，但不增加放疗反应及并发症。     

放疗,放化疗结合治疗中晚期食管癌

为了观察在放疗的同期追加化疗能否提高对中晚期食管癌的疗效,将１５６ 例中晚期食管癌随机分成Ａ、Ｂ２ 组,每组７８ 例。Ａ组：每周放疗６ 次,每次２ Ｇｙ;Ｂ组：放疗方式同Ａ 组,另于周末（ 放疗休息日）化疗,ＰＤＤ２０ ｍｇ 、５Ｆｕ ０．５ ｇ／ｍ ２ ,静脉滴注共５ 次。各组照射总肿瘤量为６４ ～７０ Ｇｙ 。随访结果：１、２、３ ａ 生存率,Ａ组分别为６９ ．２ ％（５４／７８） 、２３．１ ％ （１８／７８）和１２ ．８ ％ （１０／７８） ;Ｂ 组分别为７９ ．５％ （６２／７８）、４８ ．７％ （３８／７８）和２０．５ ％（１６／７８）。Ｂ 组２ ａ 生存率明显高于Ａ 组（Ｐ＜ ０．０１）,１、３ ａ 生存率２ 组无显著性差异（Ｐ＞ ０．０５）。结果显示,采用每周６ 次、每次２ Ｇｙ 放疗＋ 周末化疗方式治疗中晚期食管癌,近期疗效优于单纯放疗组,无明显毒副作用。     

后程加速超分割放疗中胸段食管癌临床Ⅲ期试验

目的采用前瞻随机性研究，探讨后程加速超分割放疗（ｌａｔｅｃｏｕｒｓｅａｃｃｅｌｅｒａｔｅｄｈｙｐｅｒｆｒａｃｔｉｏｎａｔｉｏｎｒａｄｉｏｔｈｅｒａｐｙ，ＬＣＡＨＲ）能否提高中胸段食管癌疗效。材料与方法１９９２年４月到１９９４年６月，１０４例中胸段食管癌经分层随机分加速超分割治疗组（Ｅ组）５１例，常规治疗组（Ｃ组）５３例，两组患者一般临床资料差异无统计学意义。放射总剂量Ｅ组：６５．６±１．９Ｇｙ，照射３６（３４～３８）次／３８（３６～４７）天；Ｃ组：总剂量６６．０±１．３Ｇｙ，照射３３（３２～３４）次／４５（４３～５０）天。结果急性放射性食管炎Ｅ组８８％，Ｃ组７２％（Ｐ＝０．０１５）。Ｅ组在不同随访期有２例死于食管大出血，１例出现放射性肺炎。１，２，３年局控率Ｅ组为７８％、５７％、４３％而Ｃ组为５８％、３６％、２６％（Ｐ＝０．０４７）；１，２，３年生存率Ｅ组为７５％、５１％、４１％而Ｃ组为５６％、３６％、２３％（Ｐ＝０．０４２）。结论（１）后程加速超分割放疗能为患者耐受。（２）后程加速超分割放疗提高了局控及生存率。     

前程加卡铂后程野中野加速超分割放射治疗食管癌90例临床观察

目的探讨前程加卡铂后程野中野加速超分割放射治疗食管癌的疗效。材料与方法自１９９１年１０月至１９９３年６月对９０例食管癌病人随机分常规放射治疗组（常规组）和前程加卡铂后程野中野加速超分割放疗组（前化后超组）各４５例。两组临床资料相近，具备可比性。常规组每周照５次，每次２Ｇｙ，总量６０～７０Ｇｙ；前化后超组前３周放疗同常规组，配合卡铂每周两次，每次１００ｍｇ，总量６００ｍｇ。第４，５周在原照射野中设小野（同病变长度），每次１．５Ｇｙ，每周５次，上午照大野，下午照小野，总量５周６５Ｇｙ，其中大野５周５０Ｇｙ，小野后两周１５Ｇｙ。结果放疗结束时Ｘ线改善前化后超组病灶全消和消失１／２以上８６．７％（３９／４５），常规组５７．８％（２６／４５）（Ｐ＜０．０１）。１，２，３，４年生存率分别为７５．６％、５３．３％、４２．２％、３３．３％和５５．６％、３１．１％、２０．０％、１５．６％。前化后超组明显好于常规组（Ｐ＜０．０５）。结论前程配合卡铂后程大野套小野加速超分割放射治疗能显著提高食管癌１，２，３，４年生存率，病人能顺利完成疗程。     

加速超分割放射治疗食管癌的临床初步观察

为了观察加速超分割放射治疗食管癌的耐受性和临床效果，作者自１９９２年１０月至１９９３年５月，将４０例胸段食管鳞癌病人随机分为加速超分割放射治疗组（２０例）和常规放射治疗组（２０例）。常规组１．８Ｇｙ／次，总量７０．２Ｇｙ，３９次，５５天。加速超分割组分为二个阶段：第一阶段１．１Ｇｙ／次，２次／日，间隔至少６小时，总剂量为３０．８Ｇｙ，２８次，２０天；第二阶段３次／日，１．１Ｇｙ／次，间隔４～６小时，总量３３Ｇｙ，３０次，１４天。两阶段总量６３．８Ｇｙ，５８次，３４天。近期疗效分析，加速超分割组ＣＲ５０％，常规组ＣＲ３０％。ＣＲ＋ＰＲ分别为９０％和９５％。预计治疗增益因子１．１３。急性反应主要为Ⅰｏ和Ⅱｏ食管炎，加速超分割组（１８／２０）发生率明显高于常规组（４／２０），但患者均能耐受。３年随访率为１００％，超分割组３年生存率４０％（８／２０），常规组２０％（４／２０），Ｐ＜０．０１，有非常显著性差异。初步结果显示加速超分割放射治疗食管癌，可望提高生存率，病人能耐受，作者认为此方案是可行的。     

连续加速超切割与后程加速超分割治疗食管癌

目的 比较连续加速超分割（ＣＡＨＦ）和后程加速超分割（ＬＣＡＦ）放射治疗食管癌的疗效和毒性。方法 １０１例食管鳞癌患者前瞻性随机分成２个组。ＬＣＡＦ组（５２例）前２／３疗程为常规分割（５次／周,１．８Ｇｙ／次）,照射４１．４Ｇｙ后缩野改加速超分割（２次／ｄ,１．５Ｇｙ／次）照射２７Ｇｙ,总量６８．４Ｇｙ,４１次,４４～４６ｄ,ＣＡＨＦ组（４９例）从治疗开始,２次／ｄ,１．５Ｇｙ／次,照射至３９Ｇｙ     

肺鳞癌单纯放射治疗159例分析

１９７７～１９８６年对１５９例肺鳞癌作单纯￣６０Ｃｏ放疗。结果：总剂量６０Ｇｙ以上组其１、３、５年生存率分别为７２．９％、２１％和１１．３％，而低于６０Ｇｙ组无３年生存。局部复发率６０Ｇｙ组为４２．９％，低于５０Ｇｙ组为７８．６％（Ｐ＜０．０５）。分割剂量２Ｇｙ／次组局部控制率为６８．８％，低于１．６Ｇｙ／次组为３５．５％。故分割剂量、总剂量以２Ｇｙ／次６０～７０Ｇｙ／６～７周为宜。     

鼻咽癌超分割放疗临床研究

１９９２年５月至１９９３年１０月将６２例鼻咽癌病人随机分为常规放疗组和超分割放疗组。常规放疗组每日１次，１．８～２．０Ｇｙ／次，每周五次，总量６８～７０Ｇｙ／３４～３７次／７～７．４周。超分割放疗组１．１Ｇｙ／次，每日２次，间隔≥６～８小时，总量７４～７７Ｇｙ／６６～７０次／７周。急性粘膜反应超分割放疗组重于常规放疗组（Ｐ＜０．０５），经系统口咽处理病人可以耐受，放疗结束后６个月，临床与ＣＴ检查鼻咽肿瘤退缩率两组基本相同。两年生存率和无瘤生存率，常规放疗组分别为８３．９％和７４．２％。超分割放疗组分别为９０．３％和８３．９％（Ｐ＞０．０５），近期疗效超分割组略优于常规放疗组，放疗后主要后遗症（张口困难、口干、放射性龋齿等）超分割组明显轻于常规放疗组（Ｐ＜０．０５）。     

后程加速超分割放射治疗食管癌的技术与结果

１９８８年４月至１９９０年４月对８５例食管鳞癌进行常规分割和后程加速超分割放疗随机前瞻研究。常规分割组４２例，每周￣６０Ｃｏ放射５次，每次１．８Ｇｙ，总疗程７．６周照射６８．４Ｇｙ。后程加速超分割组４３例，放射前程为常规分割，每次１．８Ｇｙ。４．６周照射２３次共４１．４Ｇｙ，然后缩野，每周照射５天，每天２次，每次１．５Ｇｙ，间隔４小时以上，１．８周照射１８次共２７Ｇｙ，总疗程６．４周，总剂量６８．４Ｇｙ。后程加速超分割放疗组１、２、３年食管局部病灶控制率和生存率分别为６９．０％，６１．９％，５９．５％和７２．１％，５５．８％，４１．９％。常规分割组分别为３９．０％，３１．７％，２９．３％和４７．６的，２６．２％，１９．０％。后程加速超分割放疗组的局部控制率和生存率明显高于常规分割放疗组。     

Ⅲ期非小细胞肺癌同步放化疗与单纯放疗的临床研究

目的：观察同步放化疗与单纯放疗治疗不能手术的ⅢＡ、ⅢＢ期非小细胞肺癌（ＮＳＣLＣ）的生存情况。方法：６２例ⅢＡ、ⅢＢ期ＮＳＣＬＣ患者被随机分成同步放化疗组（ｎ＝３２）和单纯放疗组（^ｎ＝３０）。单纯放疗组为原发灶和区域淋巴结前程超分割照射,每次１.２Ｇｙ,每天２次,总量４５.６Ｇｙ;后程加速超分割照射,每次1.６Ｇｙ,每天２次,肿瘤灶总量为６８Ｇｙ。同步放化疗组在放疗同时给予足叶乙甙５０ｍｇ／ｍ^２,顺铂２０ｍｇ／ｍ^２,第１～３、１５～１７、２９～３１天。结果：同步放化疗组中位无疾病进展生存期（ＰＦＳ）为１２个月,显著高于单纯放疗组８个月（Ｐ＝０.００２）。同步放化疗组中位总生存期（ＯＳ）为１６个月,显著高于单纯放疗组１４个月（Ｐ＝０.０１１）。同步放化疗组的１年生存率为８１.３％（２６／３２）,单纯放疗组的１年生存率为６３.３％（１９／３０）,两组无统计学差异（Ｐ＝０.１１４）。同步放化疗组的３年生存率为２5.５％,显著高于单纯放疗组３.３％（Ｐ＝０.０１６）。同步放化疗组的５年生存率为１５.６％,显著高于单纯放疗组０（Ｐ＝０.０２４）。结论：化、放疗同步治疗与单纯放射治疗相比能显著提高不能手术治疗的ⅢＡ、ⅢＢ期ＮＳＣＬＣ患者的长期生存率。     

洛铂或顺铂联合5-Fu同步放化疗治疗不能手术的中晚期食管癌的临床观察

目的：观察洛铂或顺铂联合5-Fu同步放化疗治疗不能手术的中晚期食管癌患者的近远期疗效和患者不良反应。方法60例中晚期食管鳞状细胞癌患者随机分成2组。实验组36例,洛铂30 mg／m2静脉滴注2 h,d1,5-Fu 500 mg／m2,静脉推注d1～d5,21 d为1周期,共4周期;对照组24例,顺铂30 mg／m2静脉滴注d1～3,5-Fu 500 mg／m2,静脉推注d1～d5,21 d为1周期,共4周期。同时2组均采用后程加速超分割三维适形放疗：首先运用常规分割照射1．8 Gy／d,5次／周,共23次,DT 41．4 Gy,接着进行加速超分割照射1．5 Gy,每日2次,9日共27 Gy,全程6～7周,照射DT 68．4 Gy。结果全部患者均完成治疗,洛铂组和顺铂组近期有效率各自为86．1％与66．7％,洛铂同步放化疗组和顺铂同步放化疗组的1年与2年生存率试验组与对照组各自为83．3％,61．1％和66．7％、41．6％。不良反应方面,洛铂组血小板下降发生率（66．7％）高于顺铂组（62．5％）,但差异无统计学意义（P＞0．05）;肾毒性、神经毒性发生率比较差异无统计学意义（P＞0．05）;洛铂组未出现Ⅲ～Ⅵ度胃肠道反应（0例,0％）,远远低于顺铂组（5例,20．8％）,差异具备统计学意义（ P＜0．05）。结论洛铂联合5-Fu同步放化疗治疗中晚期食管癌是安全有效的,且不良反应轻微,可以将其进行临床方面的深入推广,但仍需扩大病例数深入评价。     

同步放化疗和新辅助化疗治疗ⅡB～ⅢB期子宫颈癌的疗效分析

目的探讨同步放化疗治疗ⅡB～ⅢB期子宫颈癌的疗效。方法将126例ⅡB～ⅢB期子宫颈癌患者随机分为同步放化疗组（治疗组）和化疗后放疗组（对照组）。对照组62例外照射加腔内治疗,当放疗剂量达到30Gy时用^192Ir腔内治疗,7．0Gy／次,1次／周。当外照射剂量达到46Gv时中间挡铅。A点剂量65～70Gy,B点剂量50—56Gy结束放疗,在放疗开始前给予顺铂（DDP）20mg静脉滴注,第1天至第5天,5-氟尿嘧啶（5-Fu）750mg静脉滴注,第1天至第5天,每28d重复。2个周期结束后开始放疗,放疗结束后继续原方案化疗2个周期,共4个周期。治疗组64例,放射治疗同对照组,在放疗开始时给予DDP20mg静脉滴注,第1天至第5天,5-Fu 750mg静脉滴注,第1天至第5天,每28d重复,共用4个周期。结果全部病例随访5年以上,随访率9414％。治疗组3、5年生存率分别为82．8％、65．6％;对照组3、5年生存率分别为67．7％、46．8％,两组差异有统计学意义（x^2=3．86,P〈0．05;x^2=5．01,P〈0．05）。两组生存曲线比较差异有统计学意义（x^2=4．26,P〈0．05）,不良反应差异无统计学意义。结论同步放化疗治疗晚期子宫颈癌疗效好,可以提高3、5年生存率。不良反应无明显增加。     

Non-randomized clinical study comparing chemotherapy plus radiotherapy with radiotherapy alone in neoadjuvant therapy for oral cancer

Neoadjuvant therapy plays an important role for organ preservation and survival rate in the treatment of oral cancer. We clinically compared the effect of neoadjuvant radiotherapy and chemoradiotherapy in patients with oral cancer. We retrospectively examined 47 patients diagnosed with oral squamous cell carcinoma who underwent neoadjuvant therapy followed by curative surgery in the oral and maxillofacial surgery department of Ehime University Hospital. We divided them into two groups: radiotherapy alone (24 cases) and chemoradiotherapy (23 cases). The patients in the radiotherapy group underwent irradiation of 32.6 +/- 5.0 Gy (mean +/- SD). The patients in the chemoradiotherapy group received a low-dose fraction of cisplatin (8 mg/mm2/day, 5 days a week; total dose: 139.4 +/- 67.1 mg) and 5-fluorouracil (300 mg/mm2/day, 5 days a week; total dose: 5,900 +/- 1,839.8 mg) combined with simultaneous irradiation of 31.0 +/- 3.2 Gy. None of the 24 patients had a complete response to radiotherapy alone and 12 (50%) had a partial response. Six (26%) of the 23 patients had a complete response to chemoradiotherapy and 12 (52%) had a partial response. The primary control rate (82.6%) to chemoradiotherapy was higher than that (67.5%) to radiotherapy alone although no significant difference was found. The 5-year survival rate was 64.3% in the radiotherapy group and 62.8% in the chemoradiotherapy group. The findings of the present study suggest that while the combination of radiation and cisplatin/5-fluorouracil in neoadjuvant therapy for oral cancer may not bring a significant benefit to improve survival rate, the primary local control rate is improved in comparison with radiotherapy alone.     

A prospective randomized multicentre phase III trial of fotemustine plus whole brain irradiation versus fotemustine alone in cerebral metastases of malignant melanoma

The main objective of this prospective multicentre randomized phase III study was to compare a combined regimen of fotemustine plus whole brain irradiation with fotemustine alone in terms of cerebral response and time to cerebral progression in patients with melanoma cerebral metastases. Seventy-six patients were randomized to receive either fotemustine (arm A, n = 39) or fotemustine plus whole brain irradiation (arm B, n = 37). Fotemustine was administered intravenously at 100 mg/m(2) on days 1, 8 and 15, followed by a 5 week rest period, then every 3 weeks in non-progressive patients. In arm B, concomitant whole brain irradiation was performed at a total dose of 37.5 Gy (2.5 Gy/day on days 1-5 for three consecutive weeks). Although patients who received fotemustine alone had worse prognostic factors, there was no significant difference in cerebral response (arm A, 7.4%, arm B, 10.0%) or control rates (objective responses plus stable disease) after 7 weeks (arm A, 30%; arm B, 47%) or in overall survival (arm A, 86 days; arm B, 105 days). However, there was a significant difference in favour of arm B for the time to cerebral progression (P = 0.028, Wilcoxon test). In conclusion, fotemustine plus whole brain irradiation delayed the time to cerebral progression of melanoma cerebral metastases compared with fotemustine alone but without a significant improvement in terms of objective control or overall survival.     

Hyperfractionated radiotherapy in advanced squamous cell carcinoma of the head and neck

From January, 1976 to January, 1980, 141 patients (135 males and 6 females) with Stage III and IV squamous cell carcinoma of the head and neck received a split course of hyperfractionated radiotherapy (HFR). In the first group, involving 91 patients, the therapeutic schedule was as follows: first and fourth week, 7.2 Gy per day in 8 sessions of .9 Gy from Monday to Friday, the second and third week no irradiation was given. Thus, patients were given 72 Gy total dose, fractionated into 80 sessions. Mucosal necrosis and severe hemorrhage were responsible for the death of 26 patiens (28%). Therefore the therapeutic protocol was altered for the 50 patients of the second group: during the first and sixth week 6.6 Gy per day in 6 sessions of 1.1 Gy from Monday to Friday. The total dose was thus reduced to 66 Gy fractionated into 60 sessions, resulting in the decrease of toxicity. Regardless of the therapeutic protocol and site of primary, 114 patients (80%) achieved a complete remission and 8 showed a partial remission (>50%), whereas no change was seen for the 19 remainders. Local recurrence appeared in 60 patients (48%). Acute mucositis and laryngeal edema regularly occurred a week after every course of HFR and were considered severe in 40 patients. In spite of toxicity, the median survival is 14 months and 22 patients are still alive in November 1981: 19 without disease, and 8 of these patients have a survival time of at least 3 years.     

不均等分割放射治疗口腔癌的临床研究

 1986年1月至1993年12月,102例口腔部进行放射治疗,其中不均等分割51例。剂量分布：6Gy（A）→1．2Gy（B）→1．2Gy（A）→1．2GY（B）→1．2GY（A）,休息二天后再重复。总肿瘤量64．8Gy/6W（10．8Gy／W×6）。同期对照组51例均等分割放疗,总肿瘤量66Gy／6．5W（10Gy／W×6．5）。结果 近期疗效,不均等分割组为96．1％,均等分割组为74．5％;5年生存率不均等分割组为43．1％,均等分割组为21．6％。因此,两组有显著性差异（P＜0．05）。     

逐步递量加速超分割放射治疗食管癌

目的　观察逐步递量加速超分割放射治疗 (EHART)食管癌的近期疗效和放射副作用。方法　 60例II～III期食管鳞癌病例随机分为两组 ,常规分割放射治疗 (CFRT)组 3 0例 ,方法为 2Gy/次 ,5次 /周 ,总剂量 60Gy ,3 0分次 ,6周完成 ;EHART组 3 0例 ,方法为放射治疗的第 1～ 2周 ,1 8Gy/次 ,每天 1次 ,第 3周为 1 2Gy/次 ,每天 2次 ,间隔 6h以上 ,第 4周为 1 4Gy次 ,2次间隔 6h以上 ,第 5周为 1 6Gy次 ,2次间隔 6h以上 ,总剂量 60Gy ,40分次 ,5周完成。结果　CFRT组原发灶完全缓解 (CR) 3 6 7% (11/ 3 0 ) ,部分缓解 (PR) 3 6 7% (11/ 3 0 ) ,无变化 病变进展 (NR PD)占 2 6 7% (8/ 3 0 ) ,总有效率为 73 3 % ;EHART组CR占 5 0 0 % (15 / 3 0 ) ,PR占43 3 % (13 / 3 0 ) ,NR PD占 6 7% (2 / 3 0 ) ,总有效率为 93 3 %。EHART组明显优于CFRT组 ,两组差异有显著性意义 (P <0 0 5 ) ;而放射治疗副反应和并发症两组差异无显著性意义 (P >0 0 5 )。结论　EHART能为食管癌患者耐受 ,没有明显增加放射治疗副作用及并发症 ,有较好的近期疗效。 1、3、5年生存率及晚期损伤有待进一步随访。     

Phase II study of concurrent chemoradiotherapy with use of uneven fractionation for the treatment of glioblastoma

Background A phase II one-arm study was performed to evaluate the efficacy and safety of concurrent chemoradiotherapy with the use of uneven fractionation in glioblastoma patients. Methods A total of 19 glioblastoma patients underwent concurrent chemoradiotherapy with the use of uneven fractionation. Vincristine (VCR) and 3-[(4-amino-2-methyl-5-pyrimidinyl)methyl]-1-(2-chloroethyl)-1-nitrosourea hydrochloride (ACNU) were administered on day 1 and day 2, respectively. Irradiation at a dose of 3 Gy was administered on days 3 and 4, and at a dose of 1.5 Gy from day 5 on. The treatment was repeated at 10 day intervals. The total radiation dose was 57 Gy. Results All 19 patients received full dose irradiation. However, 8 patients required treatment interruption, and 2 patients required decreases in drug dosages due to the effects of acute toxicity such as, myelosuppression, liver function disorder and skin toxicity. The treatment responses were recorded as CR in 5, PR in 1, and NC in 10 patients. The remaining three patients received total removal of the enhancing area on CT or MRI. The 1 year and 2 year survival rates were 73% and 23%, respectively. The median survival times of this study and the historical controls were 16 months and 15 months, respectively. Conclusion The concurrent chemoradiotherapy failed to prolong the survival of glioblastoma patients.     

中晚期食管癌后程加速超分割适形放疗同期化疗的临床观察

目的：分析中晚期食管癌后程加速超分割三维适形放射治疗同期化疗的疗效、不良反应及失败原因。方法：将食管鳞癌80例随机分为普通放化组和后程加速超分割放疗同期化疗组（后加放化组）。普通放化组常规设野照射,40Gy左右改野,总剂量DT 64-70Gy,32-35分次,全疗程35-45d。两组均于放疗前和第3-4周化疗2周期：DDP 30mg/m2,d1-d3,5-FU 500mg/m2d1-d5,CF 0.2,d1-d5。后加放化组三维适形放疗,常规分割照射DT 30-36Gy后后程加速超分割适形照射：1.5Gy/次,2次/d,共34-36Gy左右,总剂量为DT 66-70Gy,全疗程35-42d。结果：整个研究随访时间1-56个月。后加放化组的1、2、3、4年生存率分别为69.5%、55.8%、43.7%和38.9%,高于普通放化组的55.0%、39.7%、28.4%和22.1%（P〈0.05）;后加放化组1、2、3、4年的局部控制率分别为72.0%、62.6%、59.1%、55.2%,稍高于普通放化组的64.6%、50.5%、47.1%、39.4%,但差异无统计学意义（P〉0.05）。两组发生急性放射性气管炎、放射性食管狭窄和放射性肺纤维化的强度分布无显著性差异（P〉0.05）,但后加放化组的Ⅲ、Ⅳ级严重的急性食管炎明显增多（P〈0.001）。普通放化组死于未控和局部复发的比例为53.3%（16/30）,高于后加放化组的42.1%（8/19）,但差异无统计学意义（P〉0.05）。结论：后程加速超分割适形放疗食管癌同期化疗提高了1、2、3、4年生存率,但Ⅲ、Ⅳ级严重的急性食管炎明显增多,最后结论还需要更深入的研究。     

非小细胞肺癌三维适形放射治疗临床研究

 目的 比较三维适形放射治疗（3DCRT）和立体定向放射治疗（SRT）圆形准直器系统治疗非小细胞肺癌（ NSCLC）的临床疗效。方法 64例NSCLC患者随机分为治疗组（3DCRT组）和对照组（SRT组），均常规放射治疗40 Gy后，再分别应用3DCRT和SRT加量照射，两组均为4～5 Gy／次，6～7次，隔日1次，每周3次，总量28～35 Gy，2～3周完成。结果 3DCRT组和SRT组有效率分别为87.9 ％和64.5 ％，差异有统计学意义；3DCRT组和SRT组1、2、3年生存率分别为74.6 ％、51.5％、36.2 ％和71.2 ％、48.9 ％、26.5 ％。中位生存时间分别为23和18个月，差异均无统计学意义；3DCRT组和SRT组正常组织并发症发生率（NTCP）分别为27.3 ％和48.4 ％，差异有统计学意义。结论 3DCRT可有效提高NSCLC患者肿瘤局部控制率和生存质量。