食管癌放射治疗前程合并化疗后程加速超分割治疗的临床探讨

目的：评价前程加用化疗后程加速超分剖放射治疗食道癌的疗效与毒性。方法：对符合入组条件的100倒，随机分为单放组50例和化放组50例。单放组前程常规分割放射30Gy，后程加速趣分割放射30Gy．每次1．5Cy．每天2次，间隔6h以上。化放组前程在单放组放射治疗基础上每周六静脉输注顺铂50mg．5-氟脲嘧啶500mg。共3周．后程同单放组。结果：化放组和单放组的1．2年生存率分别为86．0％。78．0％，78．0％和66．0％．但无统计学差异（p〉0．05）。肿瘤局部控制率加用化疗后提高．化放组和单放组1、2年局部控制率分别为82．0％、72．0％和60．0％、40．0％。两组比较统计学上有显著差异（p〈0．05）；毒副反应化放组较单放组高，但患者一般均能耐受，未见心、肝、肾的功能损害。结论；前程加化疗后程加速超分割放射治疗能明显提高食道癌的局部控制率。远期生存率有待进一步随访。

EARLY COURES CONCURENT CHEMOTHERAPY AND LATE COURSE ACCELERATED HYPERFRACTIONATION RADIOTHERAPY FOR ESOPHAGEAL CARCINOMA

Objective:To assess the effects and toxicity of early course concurrent chemotherapy plus late course accelerat- ed hyperfractionation radiotherapy(LCAHR)on esophageal carcinoma.Method:100 patients with squamous carcinoma of thoracic esophagus were divided randomly into two groups:1.LCAHR group,patients were irradiated 2.0Gy/f,5 times a week to a total does of 30 Gy early course and then irradiated by 1.5Gy/f,2 times a day(at more than 6 hours'interval),to the total dose of 60 Gy:2.C+LCAHR group,The radiotherapy technique was the same as the LCAHR group,but weekly 50mg DDP and 500 mg 5-Fu were added simultaneously for 3 weeks in early course.Method:The 1-and 2-year survival rates were 86.0%,78.0% in the C+LCAHR and 78.0 %,66.0 % in the LCAHR(P>0.05):the 1-and 2-year local control rates were 82.0%, 72.0 % in the C+LCAHR and 60.0 %,40.0 % in the LCAHR(p<0.05).The acute toxic effect was severer in the C+LC- AHR group than LCAHR,but no cardiac,hepatic and renal injury was found and all patients could tolerate them.Conclusion:Ear- ly course concurrent chemotherapy and late course accelerated hyperfractionation radiotherapy on esophageal carcinoma can signifi- candy improve the local control of esophageal carcinoma,but the survival rate needs further follow-up.