胸上中段食管癌后程加速外照射联合腔内放疗的临床分析

目的 探讨中上段食管癌后程加速外照射联合腔内放疗的疗效。方法112例中上段食管癌患者随机分为56例后程加速超分割放射治疗（后超组），开始常规分割放疗，为5次／周，2.0Gy／次，总量30Gy／3周，然后改2次／天，1．5Gy／次，间隔6小时以上，共2周。56例后程加速1周，腔内放疗2周（腔内组），腔内放疗采用低剂量率192Ir，食管黏膜参考点剂量3．0Gy／次，每周一、周五，共2周，总量12Gy／4次。结果后超组和腔内组近期有效率分另q为98．2％、100％（P〉0．05）。3、5年生存率分别为48．2％、51．7％（P〉0．05）；35．7％、37．5％（P〉0．05），两组无差异显著性，3、5年局部控制率分别为69．6％、73．2％；53．5％、57．1％（P〉0．05），两组无差异显著性。结论后程加速联和腔内放疗，能有效控制肿瘤，值得临床应用。

Clinic Analysis on Late Course Accelerated Hyperfractionation Radiotherapy and Brachytherapy for Carcinoma of Upper and Mid- thoracic Esophagus

Objective To study the clinical result of late course accelerated hyperfractionation radiotherapy(LCAHR) and brach ytherapy for carcinoma of upper and mid-thoracic esophagus.Methods 102 patients esophagus were divided randomly into two groups: 56 patients LCAFA group,patients were irradiated 2.0 Gy/f,5 times a week,30Gy/3w,then followed by 1.5Gy/f bid,at more than 6 hours` interval,30 Gy/2w.LCAHR B group,patients were irradiated with LCARF to 4 weed,then delivered with low dose rate 192Ir,3.0 Gy/f,on the esophagus mucosa,2f/w,total 12 Gy/2w.Results There were no significant difference evaluation right after the treatment between the two groups(P>0.05).The 3-,5-year survival rates were 48.2 %,35.7 % in LCAHR group and 51.7 %,37.5 %in LCAHR B group,the difference was not significant(P>0.05).The 3-,5-year local control rates were 69.6 %,53.5 % in LCAHR group and 73.2 %,57.1 % in LCAHR B group(P>0.05).Conclusions Late course accelerated hyperfractionation and therapy may control the effect of upper and mid-thoracic esophagus.How to improve the survival rates,chemotherapy or modalities need to be investigated and warrants further study.