食管癌后程加速超分割放射合并顺铂治疗的临床研究

目的：探讨同期应用顺铂能否提高后程加速分割（后超）放射治疗食管癌的疗效。方法：对 符合入组条件的81例病例， 随机分为后超组41例常规分割30Gy＋加速超分割（1．5Gy/次，2次／d)30Gy] 和综合组40例在后超组基础上静脉输注顺铂（20mg/d、连用5d为1周期、分别在第1、4周实施）共2个周期）。结果：综合组和后超组的1、3年生存率分别为80．0％、73．2％和40．0％、34．2％，但无统计学差异。肿瘤局限在食管壁的病例加用顺铂后生存率提高，综合组和后超组的3年生存率分别为66．7％、25．0％（P＜05）；早、晚期放射反应综合组较后超组高，综合组有3例顽固性咽下疼痛， 反复发作3个月以上。结论：后程加速超分割放射治疗加用顺铂未能明显提高食管癌放射治疗的生存率，但对浸润局限在食管壁的病例能明显提高3年生存率。

Combined cisplatin and late course accelerated hyperfractionation radiotherapy for cancer of the esophagus

Objective To assess the effects of combined late course accelerated hyperfractionation radiotherapy (LAHR) and cisplatin in treating esophageal cancer. Methods From March to November 1997, 81 eligible esophageal cancer patients were randomized into two groups:41 patients in the LAHR group who first recevied 30 Gy by routine fractionation,followed by 30 Gy, 1.5 Gy twice daily, five days per week and 40 patients in the combined goup who, in addition to the LAHR, receive two cycles of cisplatin infusion,20 mg/d for five consecutive days as one cycle in the first and fourth weeks.Results The 1- and 3-year survival rates of the combined and LAHR groups were 80.0%,73.2% and 40.0%,34.2% though without statistical significance (P>0.05). The 3-year suvival rates of patients whose lesions were confined to the esophageal wall were 66.7% in the combined group and 25.0% in the LAHR group (P<0.05). There were higher incidence of the early and late radiation side-effects in the combined group among whom three patients experienced recurrent but persistant pain upon degglutition which lasted for more than three months.Conclusion Notwithstanding the failure of combined cisplatin and late course accelerated hyperfractionation radiotherapy in raising the survival over the latter method alone,the former is able to obviously improve the 3-year survival rate of esophageal cancers which are confined within esophageal wall.