98例食管癌加速超分割放疗的临床研究

目的：评价加速超分割放射治疗食管癌的疗效。方法：从１９９０年１０月至１９９２年５月我们对９８例经病理证实为食管鳞癌的患者进行了研究。随机分为常规组和加速超分割组。常规组：１８０～２００ｃＧｙ／次，５次／周，总量６０００～７０００ｃＧｙ／６～７周；加速超分割组：１５０ｃＧｙ／次，２次／日，间隔６小时以上，总量５４００ｃＧｙ／３．５周。两组患者均采用６０Ｃｏ远距离外照射。结果：常规组１，３，５年生存率分别为４６％（２３／５０）、２０％（１０／５０）、１２％（６／５０）；加速超分割组１，３，５年生存率分别为７０．８％（３４／４８）、３９．６％（１９／４８）、２９．２％（１４／４８），加速超分割组明显优于常规组（Ｐ＜０．０５），而两组放疗反应和并发症无明显差异。结论：我们的初步研究显示：加速超分割放疗能明显提高食管癌患者的生存率，但不增加放疗反应及并发症。

Accelerated Fractionation Radiotherapy for Esophageal Carcinoma

Purpose:To evaluate the effect of accelerated fractionation radiation therapy for esophageal carcinoma. Methods: From October 1990 to May 1992, 98 patients with histologically proven squamous cell carcinoma of esophagus were treated either by conventional radiotherapy at 180 200cGy per day 5 times a week to a total dose of 6000 7000cGy for 6 7 weeks or by accelerated fractional regime consisting of 150cGy twice a day with an interval of 6 hours between fractions to a total dose of 5400cGy/3.5 weeks.The same Cobalt 60 teletherapy machine was used in all the patients. Results: The 1 , 3 and 5 year survival rates of patients were 46% (23/50), 20%(10/50), 12%(6/50) in conventional radiotherapy group, and 70.8%(34/48), 39.6%(14/48), 29.2%(14/48) ( P < 0.05) in accelerated fractional radiotherapy group respectively.There was no significant difference found in clinical symptoms between these two groups. Conclusion: The preliminary results from our study has shown that accelerated fractionation schedule for radiotherapy of esophageal carcinoma can give better survival than that of conventional radiotherapy with no increase of untoward radioreaction and complications.