三维适形后程加速超分割放射治疗中晚期食管癌

 【摘要】　目的　探讨三维适形（3DCRT）后程加速超分割放射治疗中晚期食管癌的疗效及毒副作用。方法　采用3DCRT后程加速超分割放射治疗食管癌患者55例（2.0 Gy／次，5次／周，剂量36 Gy后改1.5 Gy／次，2次／d，总剂量66 Gy）与后程加速超分割放射治疗（CF）的60例食管癌患者进行比较。结果　3DCRT组和CF组的1、2、3、4年生存率分别为63.6 %、50.9 %、38.2 %、30.9 %和58.3 %、38.3 %、33.3 %、23.3 %（χ2 = 4.44，P = 0.031）；3DCRT组和CF组的1、2、3、4年局部控制率分别为72.7 %、58.1 %、47.2 %、36.3 %和53.3 %、40 %、28.3 %、20 %（χ2 = 5.33，P = 0.013）。3DCRT组的急性放射性食管炎和CF组相似，急性气管炎及血液毒性两组相似。CF组的晚期肺损伤较3DCRT组重（χ2 = 4.42，P = 0.012）。结论　3DCRT能明显提高中晚期食管癌的局部控制率和生存率，放射性反应较轻。

Three dimensional conformal radiotherapy with late course accelerated hyper-fractionation for advanced esophageal carcinoma

【Abstract】　Objective　To evaluate the results and toxic effects in three dimensional radiotherapy (3DCRT) with late course accelerated hyper-fractionation for advanced esophageal carcinoma. Methods　From December 2001 to December 2003, 115 patients were randomly divided into two groups: in 3DCRT group, 55 patients were given late course accelerated hyper-fractionation radiotherapy to a total dose of 66 Gy (2.0 Gy per fraction, 5 times per week; to a dose of 36 Gy were changed into 1.5 Gy/f, 2 f/d). In CF group, 60 patients were given late course accelerated hyper-fractionation radiotherapy to a total dose of 66 Gy. Results　The 1-,2-,3-,4-year survival rates in 3DCRT group were 63.6 %, 50.9 %, 38.2 %, 30.9 % compared to 58.3 %, 38.3 %, 33.3 %, 23.3 % in CF group(χ2 = 4.44, P = 0.031), and local control rates in 1-, 2-, 3-, and 4- years in 3DCRT group were 72.7 %, 58.1 %, 47.2 % and 36.3 %, compared to 53.3 %, 40 %, 28.3 %, and 20 % (χ2 = 5.33, P = 0.013) in CF group. However, in the 3DCRT group, the incidence of acute esophagitis was similar to CF group; hematogenous toxic and acute bronchitis were similar between the two groups. Late course lung injury in CF group was higher than that in 3DCRT group. Conclusion　3DCRT is able to improve the local control rate and survival rate, and unable to improve acute and late radiation toxic effects.