食管癌连续7天常规分割加速放射治疗的远期疗效分析

目的连续7d常规分割加速放射治疗方案和后程加速超分割放射治疗方案治疗食管癌的疗效比较。方法57例食管鳞癌患者随机分为两组，连续7d常规分割加速放射治疗组（连续组）29例和后程加速超分割放射治疗组（后超组）28例。连续组治疗方法1次，d，2Gy／次，7d，周，吸收剂量60Gy，30次，30d；后超组前半程为常规分割（5次，周，2Gy／次），照射至30Gy时改加速超分割（2次，d，1．5Gy／次，5d，周），吸收剂量60Gy，共35次，33～35d。结果连续组和后超组1年、2年、3年总生存率分别为62．07％、37．93％、25．60％和64．29％、35．71％、25．00％。1年、2年、3年局部控制率连续组和后超组分别为82．93％、70．59％、52．94％和70．38％、45．95％、40．84％，3年疾病特异性生存率连续组为28．72％，后超组为25．00％。两组间晚期反应差异未见统计学意义。结论连续组3年生存率与后超组相当，局部复发、未控和转移仍是食管癌放射治疗失败的主要原因。

The long effect of 7-day continuous accelerated irradiation in patients with esophageal carcinoma

Objective The curative effect of 7-day continuous accelerated irradiation schedule (CAIR) was compared with late course accelerated hyper-fractionation radiotherapy schedule (LCAF) for esophageal carcinoma in a randomized trial. Methods Fifty-seven patients with squamous cell carcinoma of esophagus were randomly divided into two groups, 29 to the CAIR group and 28 to the LCAF group. In CAIR group dose per fraction of 2.0 Gy was given once per day at 24 h intervals and the overall treatment time was 4.2 weeks (30 days). The patients in the LCAF group received conventional fractionation radiotherapy, 2 Gy/fraction, to a dose of 30 Gy in 15 fractions during 3 weeks, followed by accelerated fractionation radiotherapy, 2 fractions per day at 1.5 Gy/fraction (with a minimal interval of 6 h between fractions), and the overall treatment time was 5 weeks. The total dose was 60 Gy in both groups. Results The 1,2 and 3-year overall survival rate were 62.07%, 37.93% and 25.60% in CAIR group and 64.29%, 35.71% and 25.00% in LCAF group. The 3-year local control rate was 52.94% and 40.84% in CAIR and LCAF groups, respectively. The 3-year cause-specific survival rate was 28.72% in CAIR and 25.00% in LCAF group. There was no significant difference of late effect in two groups.Conclusions The 3-year survival rate and local control rate were similar in two groups. The local relapse and metastasis were the main reason of failure to radiotherapy to esophageal carcinoma.