Ⅲ期食管癌几种不同分割模式照射的疗效观察

  目的 比较常规分割剂量每周照射7 d，5 d及后程加速超分割3种方法治疗Ⅲ期食管癌的疗效及放射反应。方法 对138例首治Ⅲ期食管癌病例随机分成 A、B、C组。A组46例，2.0 Gy／次，5次／周，40 ~ 47 d完成；B组46例，2.0 Gy／次，7次／周，30 ~ 35 d完成； C组46例，2.0 Gy／次，5次／周， 4周后，改为1.5 Gy／次， 2次／d，间隔6 h以上，5次／周，35 ~ 40 d完成。三组累积照射量均为60 ~ 70 Gy。结果 A、B、C组1年生存率分别为32.6 %、67.4 %、63.0 %，3年生存率分别为6.5 %、43.5 %、41.3 %，B、C组高于A组（P＜0.05）；1年局部控制率分别为34.8 %、71.7 %、69.6 %，3年局部控制率分别为17.4 %、56.5 %、56.5 %，B、C组高于A组（P＜0.05）；出血、穿孔的发生率分别为4.3 %、6.5 %、4.3 %， 3组间差异无统计学意义（P＞0.05）。结论 常规分割剂量7 d／周照射和后程加速超分割照射比5 d／周照射可明显提高疗效。

Efficacy of stage Ⅲ esophageal carcinoma treated by several fracttonated radiotherapy

Objective To evaluate the effect of radiotherapy on stage Ⅲesophageal cancer with con－ventional fraction dose 7-day-per-week and 5-day-per-week and late course accelerated hyperfraction. Method From February 1999 to June 2002 138 patients with stage Ⅲesophageal cancer were divided into 3 groups: group A, B and C. Patients in the A group received a total dose of 60 ~ 70 Gy/30 ~ 35 fraction/40 ~ 47 days, and the B group received a total dose of 60 ~ 70 Gy/30~35 fraction/30 ~ 35 days, and the C group received a total dose of 60 ~ 70 Gy/34 ~ 40 fraction/37 ~ 40 days. Results The 1-year survival rates of the A, B, C group were 32.6 %, 67.4 %, 63.0 %(Ｐ <0.05). The 1-year local tumor control rates of the three group were 34.8 %, 71.7 %, 69.6 %(Ｐ <0.05). The 3-year survival rates of the A,B,C group were 6.5 %, 43.5 %, 41.3 %(Ｐ <0.05). The 3-year local tumor control rates of the three group were 17.4 %,56.5 %, 56.5 %(Ｐ <0.05). The massive hemorrhage of the three group were 4.3 %, 6.5 %, 4.3 %, (P >0.05).Conclusion The 7-day-per-week and the late course accelerated hyperfraction radiotherapy can improve the local tumor control rate and survival rate of stage Ⅲ esophageal cancer.