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 accelearled 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 - PAt 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 -g 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.