60例胸段食管癌后程加速超分割放射治疗分析

目的]评价食管癌后程加速超分割放射治疗疗效及并发症.方法]60例食管癌随机分为2组:常规分割组30例,1次/天,2Gy/次,5次/周,总剂量65Gy,32.5分次,6.5～7周完成;后程加速超分割组30例,1次/天,2Gy/次,5次/周,总剂量达40Gy,20分次后改为2次/天,1.5Gy/次,10次/周,总剂量65Gy,36.6分次,5～6周.结果]两组1、3、5年局部控制率后程加速超分割组优于常规分割组(P＜0.05),分别为70.0%、53.3%、46.6%和56.6%、36.6%、30%;1、3、5年生存率后程加速超分割组优于常规分割组(P＜0.05),分别为73.3%、36.3%、30.0%和60.0%、26.6%、20.0%.后程加速超分割组急性反应发生率较常规分割组高,但差异无显著性(P＞0.05).结论]食管癌后程加速超分割放疗能明显提高局部控制率和生存率,不明显增加放射治疗反应及并发症.

An Analysis of Late Course Accelerated Hyperfrationation Radiotherapy in 60 Cases with Esophageal Carcinoma

To evaluate the therapeutic effect and complication of late course accelerated hyperfrationation radiotherapy (LCAHR) for esophageal carcinoma. Sixty cases with esophageal carcinoma were randomized into two groups: 30 cases entered the convention fractionation radiotherapy (CFR) group and 30, the LCAHR group. The patients of CFR group received a total dose of 65Gy/32.5F, 6.5~7w, at 2Gy daily, 5 days per week. While the LCAHR group received conventional fractions in the first part of the treatment to a dose of 40Gy/20F, 4w, followed by accelerated fractionated irradiation, twice daily at 1.5Gy per fraction with a minimum interval of hours, 5 days per week to a total dose of 65Gy/36.6F, 5.6~6w. The 1-, 3-, and 5-year local control rates were 70.0%, 53.3%, 46.6% in the LCAHR group and 56.6%, 36.6%, 30.0% in the CFR group (P<0.05), respectively. The 1-, 3-, and 5-year actuarial survival rates were 73.3%, 36.6%, 30.0% in the LCAHR group and 60.0%, 26.6%, 20.0% in the CFR group (P<0.05), respectively. The acute trachitis rate and the acute esophagitis rate in the LCAHR group were higher than those in the CFR group, but there was no significant difference between the two groups(P>0.05). Conclusions] Late course accelerated hyperfractionation radiotherapy regimen can notably improve the local control rate and the survival rate for esophageal carcinoma without increasing any untoward radioreaction or complication.