后程加速超分割放疗和常规分割加腔内放疗食管癌的回顾性分析

目的 回顾分析和比较后程加速超分割放疗（后超组）与常规分割＋腔内放疗（腔内组）食管癌的疗效.方法 对1994年5月至1999年11月间4个小样本前瞻性研究的后超组（135例）和腔内组（130例）治疗食管癌的病例进行分析比较.后超组前3周常规分割照射3000cGy（分15次3周完成）,后2周采用加速超分割照射3000 cGy（分20次2周完成;150 cGy/次,2次/d,2次相隔6 h,5d/周）.腔内组常规分割照射5000 cGy（分25次5周完成）＋腔内照射1000 cGy（分2次）.结果 后超组和腔内组1、3、5年总生存率分别为61.8%、27.9%、19.9%和53.5%、25.2%、18.4%（P＞0.05）.后超组和腔内组急性放射性食管炎的发生率分别为61.5%和57.0%（P=0.235）,且RTOG分级3级食管炎比较两组差异也无统计学意义.结论 两种放疗方式食管癌的生存率无明显差别,但后程加速超分割技术操作方便,易于在临床中实施.

Retrospective analysis on results of late course accelerated hyperfractionation radiotherapy and conventional fractionation radiotherapy plus brachytherapy for esophageal carcinoma

Objective To analyze and compare retrospectively the results of esophageal carcinoma treated with late course accelerated hyperfractionation radiotherapy(LCAHR) and conventional fractionation radiotherapy plus brachytherapy(CFRB). Methods From May 1994 to November 1999, 265 patients from four independent prospective studies were included in the analysis. 135 patients treated by conventional fractionation radiotherapy with 3000cGy/15f and then hyperfractionation radiotherapy(150cGy/d,twice)with 3000cGy/20f in the LCAHR group, and 130 patients by conventional fractionation radiotherapy with 5000cGy/25f plus brachytherapy with 1000cGy/2f(with a 6 hour`interval) in the CFRB group. Results The 1-,3-,5-year survival rate was 61.8%, 27.9%,19.9% and 53.5%,25.2%,18.4% in LCAHE and CFRB group, respectively(P>0.05). Acute esophagitis occurrence rate was 61.5% and 57.0% in LCAHE and CFRB group, respectively(P=0.235), and grade III esophagitis occurrence rate without any difference in the two groups. Conclusions The survival results show no difference between LCAHR and CFRB group. The technique of late course accelerated hyperfractionation radiotherapy, being easy to arrange, can be more easily carried out in clinical practice.