三维适形后程加速超分割放疗同步化疗食管癌的疗效观察

目的：评价三维适形（3DCRT）后程加速超分割放疗同步氟尿嘧啶＋顺铂化疗食管癌的局部控制率，生存期和毒副作用。方法：回顾性分析近2年收治的食管癌38例，应用3DCRT后程加速超分割治疗，前4周2Gy/次，1次，天，40Gy后改为1．5Gy／次，2次／天，2次间间隔6-8小时，总剂量66—68Gy，同步氟尿嘧啶＋顺铂化疗，氟尿嘧啶500mg／m2，静脉滴注第1～5天，顺铂20mg／m2静脉滴注第1-5天，21天为1周期。放疗期间化疗2周期，结束后化疗2～4周期。结果：完全缓解率79％（30例），部分缓解率13％（5例），有效率92％，吞咽困难症状改善97％，胸背库痛症状缓解率90％。1-2年生存率分别为80％、58％，生活质量明显改善，无治疗相关性死亡。结论：3DERT后程加速超分割放疗同步氟尿嘧啶＋顺铂化疗食管癌可提高局部控制率和延长生存期，提高生活质量，不良反应可耐受。

Observation on therapeutic effect of late course accelerated hyperfractionation with 3-dlmensional conformal radiotherapy combined concurrent chemotherapy for esophageal carcinoma

Objective：To evalute the efficacy of late course accelerated hyperfraetionation with three-dimersional eonformal radiotherapy（DCRT） eomblned concurrent ehemotherapy for esophageal carcinoma. Methods：Between September 2004 and August 2006,38 patients with esophageal carcinoma were treated by late eourse accelerated byperfraetionation with three-DCRT of 66-68Gy （first,in 2.0 Gy once daily, after 40 Gy,in 1.5 Gy twice daily, with a minimum of 6 h interval ）.Chemotherapy was given coneurrently using 5-FU （500 mg/m2,i.v, drop, 1-5 d） and DDP （20 mg/m2,i.v, drip, 1～5 d,21 d pereyele）. Results：After the followed-up of 12～36 moths,the total response rate,complete response rate and partial response rate were 92%（37/38）,79%（30/38）, 13%（5/38）,respeetively.Dysphagia symptoms were improved by 97% ,thoraeodorsal pain symptoms were allervated by 90% .The 1-and 2-year survial rates were 80% and 58%.The quality of life was improved without any treatment related death. Conclusion： Late course accelerated hyperfraetionation with 3-DCRT conformal radiotherapy eombined concurrent chemotherapy is effective and well tolerated in the patients with esophageal carcinoma.