后程加速超分割放疗联合消癌平治疗中晚期食管癌82例疗效观察

目的：观察后程加速超分割放疗联合中药消癌平治疗中晚期食管癌的疗效及毒副反应。方法：将符合条件的164例食管癌患者随机分为后程加速超分割放疗组（简称单放组,82例）。和后程加速超分割放疗加消癌平治疗组（简称综合组,82例）。放疗方法两组相同,前3周为常规放疗（2Gy/次,1次/天,5天/周）,后两周改为加速超分割放疗（1.5Gy/次,2次/天,间隔6小时以上,5天/周）。消癌平口服于放疗第一天开始（20ml/次,3次/天）,直至放疗结束。结果：单放组和综合组的1、3、5年生存率分别为85.4%、43.9%、20.7%;90.2%、54.9%、36.6%,5年生存率有显著差异（P〈0.05）。两组1、3、5年局部控制率分别为53.2%、29.3%、20.7%;69.5%、45.1%、40.2%,两组有显著差异（P〈0.05）。两组患者的死亡原因均以肿瘤局部未控和复发为主。综合组因肿瘤局部未控和复发的死亡率59.6%明显低于单放组80.0%。两组比较有显著性差异（P〈0.05）,综合组的造血系统和消化系统反应均明显低于单放组。结论：后程加速超分割放射治疗加消癌平治疗提高了5年生存率,但毒性并未增加。

Observations of late course accelerated hyperfractionation radiotherapy and plus chinese medicine for advanced esophageal carcinoma

Objective：To evaluate the treatment results and side -reactions of esophageal carcinoma treated with late course accelerated hyperfraction radiotherapy plus Xiao Ai Ping chemo -therapy（ LCAHR ＋ C）. Methods： One hundred and sixty four patients with carcinoma of the esophagus were randomized into two groups： LCAHR along group （82 patients） and LCAHR ＋ Xiao Ai Ping group （82 patients）. The same irradiation was given for both groups with conventional fractionation （2Gy daily,5 times a week） in the first 3 weeks and late course accelerated hyperfractionation （ 1.5Gy twice daily , a minimum interfraction interval of 6 hours ,5 days per week） in the late 2 weeks . The total dose was 60Gy/5 weeks. In LCAHR ＋ Xiao Ai Ping group, Xiao Ai Ping was given （20ml/times ,3 times/day） , continuously until radiotherapy complete. Results： The 1 -,3 -,5 -year survival rates combined and LCAFR groups were 90.2% ,54.9% ,41.5% and 85.4% ,43.9% ,24.4%. There was statistical significance in the 5 - year survival rates . The 1 - ,3 - ,5 - year local control rates were 69.5% ,45.1% ,42.2% and 53.2% ,29.3% ,20.7% （ P 〈 0.05 ）. The main death cause of two groups was local recurrence and uncontrolled tumor. The LCAFR ＋ C group was lower （56.9%） than the LCAFR group （80.0%）. There was statistical significance in the two groups （P 〈 0.05 ） . The hematopoiesis and gastrointestinal tract side - reactions in LCAFR group were more severe than those of LCAFR ＋ C group. Conclusion： Late course accelerated hyperfractionation radiotherapy used simultaneously with Xiao Ai Ping can increase the overall survival rate, reduce acute side - effect.