食管癌后程加速超分割立体定向适形放疗效果

目的评价常规加量后程加速超分割立体定向适形放射治疗食管癌的疗效。方法155例食管鳞癌患者随机分为两组:①常规分割组(CF组)75例,方法为2Gy/次,5次/周,总剂量60～70Gy,30～35分次,6～7周完成;②后超组(LCAHF组)80例,方法为先常规照射40Gy/4周,2Gy/次,5次/周,从第5周起超分割立体定向适形照射,1.5Gy/次,2次/d,间隔6h以上,24Gy/1.5周,总剂量64Gy,5.5周完成。结果1、2、3年生存率CF组为54.7%、42.7%、25.3%,LCAHF组为82.8%、61.3%、41.3%。1、2、3年局部控制率CF组为54.7%、46.7%、30.7%,LCAHF组为81.3%、63.8%、53.8%。两组有显著性差异(P<0.05),而放射治疗不良反应和并发症两组无显著性差异(P>0.05)。结论常规加量后程加速超分割立体定向适形放疗较常规分割放疗能提高食管癌的生存率和局部控制率,未明显增加放射治疗不良反应及并发症。

Study of late course accelerated hyperfractionation stereotactic conformal radiotherapy for esophageal carcinoma

Objective To evaluate the therapeutic effects of late course accelerated hyperfractionation stereotactic conformal radiotherapy for esophageal carcinoma.Methods The 155 patients with squamous cell carcinoma of esophagus were randomized into two groups:75 patients entered the convention fractionation radiotherapy(CF) group and 80 the LCAHF SRT group.The patients of CF group received a total dose of 60-70Gy,at 2Gy daily,5 days per week.While in the LCAHF group,all patients first received a mean dose of 40Gy/4wks followed by 24Gy/16fs/1.5wks,1.5Gy/fs,twice daily. DT64Gy/36fs/5.5wks were delivered.Results The 1-,2-,3-year survivals rates were 54.7%,42.7%,25.3% in the CF,and 82.8%,61.3%,41.3% in the LCAHF.The 1-,2-,3-year local control rates were 54.7%,46.7%,30.7% in the CF group,and 81.3%,63.8%,53.8% in the LCAHF group.The difference is significant(P<0.05).There was no significant differences on acute complications or specific sequelae between the two groups(P>0.05).Conclusion The later course accelerated hyperfractionation stereotactic conformal radiotherapy can improve the survival rates and local control rates of esophageal carcinoma without increasing any untoward radioreactions or complications.