100例食管癌后程加速放疗的研究

评价后程加速放疗对食管癌病人的疗效。材料与方法自１９９１年１０月至１９９３年５月对１００例食管癌病人进行了研究，随机分为两组：常规组（５０例），后超组（５０例）。两组包括颈段４例，胸上段３５例，脾中段５６例及胸下段５例。全部病人均为鳞癌。常规照射：１８０－２００ｃＧｙ／次，５次／周，总量６０００ｃＧｙ／６周；后程加速照射：前３周同常规组，共３０００ｃＧｙ／３周，第４周起，１５０ｃＧｙ／次，日２次，间隔６小时，照射量为３０００ｃＧｙ／２周，总照射量６０００ｃＧｙ／５周。结果局控率后超组９８％（４９／５０），常规组９４％（４７／５０），１，２，３年生存率分别为８４％（４２／５０）、５６％（２８／５０）、４８％（２４／５０）及６２％（３１／５０）。３４％（１７／５０）２２％（１１／５０），后超组明显好于常规组（Ｐ＜０．０１）。两组放疗副反应无差别，其主要死因是局部复发、次为出血、穿孔及远处转移，后超组死于出血、穿孔者并不多于常规组。结论后程加速照射能明显提高食管癌病人１，２，３年生存率，不增加放疗副反应及并发症。

The study of 100 patients with late course accelerated radiation for esopbageal carcinoma

Purpose To evaluate the effect of late course accelerated radiation for esophagus carcinoma Materials and Methods 100 patients with esophagus carcinoma were treated from October 1991 to May 1993 . They were randomly divided into two groups : late course hyperfraction radiation ( LCHR ) group ( 50 patients) and conventional fraction radiation ( CFR ) group ( 50 patients) , All were squamous. cell carcinoma . Patients in CFR received 1 80 cGy to 200 cGy/ per fraction, five fractions/ per week with the total doses of 6000 cGy /6 weeks. Patients in LCHR received 150 cGy/per fraction, two fractions/per day with 6 hours interval and 3000 cGy/2 weeks The total doses of 6000 cGy/5 weeks. Results The local control rates were 98 % in LCHR group and 94 % in CFR group , There was not significant difference between two groups , The one, two and three - year survival rates were 84 % (42/50) , 56 % (28/50 ) , 48 % (24/50 ) in LCHR group and 62 % ( 31/ 50),34%(17/50),22% (11/50) in CFR group, respectively. The survival rates in LCHR group were much better than that in CFR group (P < 0 . 01 ) .There was no significant difference between two groups about clinical radiotherapy symptoms . No differences of subsequent causes ( such as bleeding , fistula ) were found in both groups. Conclusion The survival rates of patients with esophageals carcinoma can be improved by LCHR without increasing any complication .