后程加速超分割放射加顺铂治疗食管癌的临床研究

目的观察后程加速超分割放疗同期单药顺铂化疗对食管癌的放射增效作用。方法将符合入选条件的104例食管鳞状细胞癌患者随机分为后程加速超分割放疗组（简称单放组，53例）和后程加速超分割放射加顺铂组（简称放化组，51例）。放疗方法2个组相同．前3周为常规放疗（2Gy／次，1次／d，5d／周），后2周改为加速超分割放疗（1．5Gy／次，2次／d，间隔6h或以上，5d／周）。顺铂于放疗第1、5周分别给予20mg／d，连续5d。结果单放组和放化组的中位生存期分别为12，2、17，0个月。单放组1、3年生存率分别为52.8％、20．8％，放化组的分别为58．0％、24.0％（P〉0．05）。放化组的胃肠道及血液方面的急性反应较明显，而急性食管炎及晚期副反应无明显增加。结论后程加速超分割放射加顺铂治疗食管癌较单纯后程加速超分割放疗有提高总生存率的趋势。

Randomized study on late course accelerated hyperfractionation radiotherapy plus cisplatin in the treatment of esophageal carcinoma

Objective To investigate the therapeutic results of late course accelerated hyperfractionation(LCAH) radiotherapy plus cisplatin as a radiosensitizer in the treatment of esophageal carcinoma.Methods One hundred and four patients with squamous cell carcinoma of the esophagus were randomized into two groups: LCAH alone group(53 patients) and LCAH + cisplatin group(51 patients).The same irradiation technique was given for both groups with conventional fractionation(2Gy daily,5 times a week) in the first 3 weeks and late course accelerated hyperfractionation(1.5Gy twice daily,a minimum interfraction interval of 6 hours,5 days per week) in the last 2 weeks.The total dose was 60Gy/5 wks. In LCAH + cisplatin group,cisplatin was given simultaneous with 20mg once daily for 5 days in the 1st and 5th weeks.The acute and late side effects were evaluated during and after the treatment.Results The median survival time was 12.2 months and 17.0 months in the LCAH alone group and LCAH + cisplatin group.The 1-and 3-year survival rates in LCAH group were 52.8 % and(20.8%);while those of LCAH + cisplatin group were 58.0 % and 24.0%(P> 0.05).The acute gastrointestinal toxicities and hematological toxicities were obvious in LCAH + cisplatin group,but no increased acute esophagitis or late complications was observed.Conclusions Late course accelerated hyperfractionation radiotherapy used simultaneously with cisplatin tends to increase the overall survival rate compared with the late course accelerated hyperfractionation radiotherapy alone in the treatment of esophageal carcinoma.