食管癌后程加速超分割放疗疗效观察

目的:探讨后程加速超分割放射治疗食管癌的疗效.方法:120例食管癌患者分为常规放射治疗组和后程加速超分割组(LCAF),加速组先常规放疗,前后对穿照射40Gy/20次(1次/d,2Gy/次,5次/周),而后复查食管X线片,在模拟机下定位后治疗,剂量为30Gy/20次(1.5Gy/次,2次/d,间隔6-8h,10次/周),2周完成.总剂量:70Gy/40次/6周.比较两种方法治疗效果及不良反应和并发症.结果:常规放射治疗组和LCAF组1年、2年、3 年局控率分别为 41.7%、28.3%、21.7%和66.7%、51.7%、46.7%(P＜0.01).1年、2年、3年生存率分别为46.7%、30%、20%和71.7%、58.3%、46.7%(P＜0.01).食管炎、气管炎、食管狭窄分别为18.3%、16.7%、3.3%和21.7%、21.7%、5%(P＞0.05).结论:后程加速超分割放射治疗食管癌的疗效比常规放射治疗提高了近1倍,虽然急性放疗反应有所增加,但患者均可耐受.

Clinical reseouch of routine radiotherapy and late -course accelearted hyperfraction radiotherapy to treat esophageal corcinoma

Objective:To discuss the effect in treatment of esophageal carcinoma by late-course accelerated hyperfractionation radiotherapy.Methods:Total of 120 cases were divided into two groups,one group was treated by routine radiotherapy and another firstly treated by routine division which was AP-PA portals irradiation 40Gy for 20 times,once everyday,2Gy every time,5 times every week,and then located by analog machine and irradiated by 2 times every day,1.5Gy every time,with 6-8 hours interval,10 times every week,30Gy for 20 times within two weeks.The total dose was 70Gy 40 times 6 weeks.Results:The routine radiotherapy group and LCAP group local control rates of one year,two year and three year were respectively 41.7%,28.3%,21.7% and 66.7%,51.7%,46.7%(P＜0.01).The survival rates of one year,two year and three year were respectively 46.7%,30%,20% and 71.7%,58.3%,46.7%(P＜0.01).The esophagitis,tracheitis and esophageal stenosis develop rates were respectively 18.3%,16.7%,3.3% and 21.7%,21.7%,5%(P＞0.05).Conclusion:The effect of late-course accelerated hyperfractionation for esophageal carcinoma treatment is higher than the routine radiotherapy,although acute radiotherapy reaction,which is acceptable,will increase.