后程加速超分割放疗食管癌的临床研究

目的研究后程加速超分割（LCAF）和常规分割（CF）放射治疗食管癌的远期疗效及毒副反应。方法64例食管癌患者随机分为LCAF治疗组和CF治疗组，其中LCAF组32例，先用常规分割照射40Gy，2Gy／次，1次／天，5次／周，4周完成，再用LCAF避脊髓照射28Gy，1．4Gy／次，2次／天，间隔4～6h，5次／周。总剂量68Gy分40次6周完成。CF组始终用常规分割照射，总剂量70Gy分35次7周完成。结果食管癌肿瘤完全缓解率LCAF组和CF组分别为63％、53％；1、3、5年肿瘤局部控制率LCAF组分别为72％、55％、17％，CF组分别为52％、18％、8％，两组有显著性差异（P〈0．05）。1、3、5年生存率LCAF组分别为68％、50％、18％，CF组分别为50％、30％、10％，两组有显著性差异（P〈0．05）。近期反应放射性食管炎LCAF纽与CF组存在差异（P〈0．05），而放射性气管炎无显著性差异（P〉0．05）。两纽并发症也无显著性差异（P〉0．05）。结论食管癌LCAF的局部控制率、长期生存率均高于CF，患者能耐受LCAF治疗，不增加远期毒副反应。

Late Course Accelerated Hyperfractionation Radiotherapy for Esophageal Carcinoma

Objective To study the long-term efficacy and toxicities of late course accelerated fractionation （LCAF） and conventional fractionation （CF） radiotherapy in the treatment of patients with esophageal carcinoma. Methods 64 patients with esophageal carcinoma were randomly divided into LCAF and CF radiotherapy groups. The 32 patients in the LCAF group were given 28 Gy in 1.4Gy/fraction,2 times a day, separated 4-6hours after 40 Gy of conventionally fractionated irradiation. Thirty-two patients in CF group received 70Gy of conventional irradiation. Results The complete response rate in the LCAF and CF group was 63% and 53%. The 1,3,5-year local control rate was 72% ,55% and 17% in the LCAF group,and 52% ,18% ,8% in the CF group. The local control rate between the two groups was significantly different （P 〈 0.05 ）. The 1,3 and 5-yaer survival rate was 68% ,50% ,18% in the LCAF group,and 50% ,30% ,10% in the CF group. The difference between the two groups was significant （ P 〈 0. 05 ）. There was significant difference in the acute esophageal raditation reaction （ P 〈 0.05 ）, but there was no significant difference in the acute trachea reaction（P 〉 0. 05 ） between the two group. There was no significant difference in late complications between the two group （P 〉 0.05 ）. Conclusion The local control rate and survival rate in LCAF group is higher than that in the CF group. LCAF radiotherapy is well tolerated with no increased toxicities.