食管癌优化放疗方案的临床研究

目的 探讨食管癌放疗优化方案的临床效果.方法 选取60例食管癌患者,将其随机分为后程常规分割三维适形放疗组（对照组）和后程加速超分割三维适形放疗组（加超组）.放疗方法均在前2/3疗程普通模拟机定位常规放疗40 Gy,后1/3疗程加超组改为CT模拟定位加速超分割三维适形放疗（剂量为1.5 Gy/次,2次/d,共计24 ～ 30Gy,总剂量为64 ～ 70Gy,36 ～ 40次,全疗程为38 ～ 42d）；对照组采用常规分割三维适形放疗（剂量为2.0 Gy/次,1次/d,总剂量为64～70Gy）.结果 加超组近期疗效明显优于对照组,差异有统计学意义（P＜0.05）；治疗后两组患者不良反应、并发症和1年生存率比较,差异均无统计学意义（P＞0.05）.结论 常规放疗后进行后程加速超分割三维适形放疗治疗食管癌的近期疗效明显提高,且不良反应未有增加,值得临床推广应用.

Optimized radiotherapy for esophageal cancer

Objective To explore the clinical efficacy of optimized radiotherapy for esophageal cancer.Methods 60 patients with esophageal cancer were randomly divided into two groups.The study group received conventional fractionated radiotherapy during the first two-thirds of the course with 40 Gy,then followed by hypeffraction 3D-CRT with 24-30 Gy for 12 to 18 days,with 1.5 Gy per fraction,and a total dose of 64-70 Gy in 36 -40 fractions for 38-42 days.The control group received the same therapy during the two-thirds of the course,but followed by conventional fractionated 3D-CRT with 2.0 Gy per fraction and a total dose of 64-70 Gy.Results The study group was superior to the control group in the short-term efficacy,with a statistical difference （P〈0.05）.There were no significant differences between the two groups in adverse reactions,complications,and one-year survival rate （P〉0.05）.Conclusions Hyperfraction 3D-CRT following conventional radiotherapy can improve the short-term efficacy of treatment for esophageal cancer and has no increase in adverse reactions.It is worth popularizing clinically.