食管癌后程加速超分割放化疗与单纯超分割放疗的疗效对比观察

目的比较后程加速超分割放疗加同期化疗与单纯后程加速超分割放疗治疗食管癌的近期疗效及毒副作用。方法 78例中上段食管癌患者随机分为两组。1）单纯后程加速超分割放疗组36例;2）后程加速超分割放疗加同期化疗组42例。放疗采用6MVX线外照射,前2/3程常规放射治疗2Gy/次,1次/d,共40次,后1/3疗程改用加速超分割放射治疗,1.2Gy/次,2次/d,间隔6h,全疗程总剂量共65Gy;化疗采用周剂量紫杉醇全身用药方案,30mg静脉滴注,每周一放疗前给药1次,共6次,用药前给予预处理。结果同步放化疗组近期有效率为83.3%,1、3、5年生存率分别为71.4%、42.8%和28.5%;单放组的近期有效率为63.8%,1、3、年生存率分别为47.2%、27.7%和13.8%。经χ2检验,差异有显著意义,两组毒副作用均可以耐受。结论以紫杉醇化疗同步后程加速超分割放疗可以提高食管癌的近期有效率及长期生存率,毒副反应所有患者均能耐受。

Synchronic radiotherapy-chemotherapy compared with radiotherapy alone in patients with upper and middle esophageal cancer

Objective To evaluate the toxicity and clinical activity of late course accelerated hyper fractionation radiotherapy plus chemotherapy （ LCAHR ＋ C ） and late course accelerated hyper fractionation radiotherapy （ LCAHR）. Methods 78 patients with mid-upper segment esophageal carcinoma were randomly divided into two groups：1） LCAFR group：36 patients 2） LCAHR ＋ C group：36 patients. Were given with 6Mvxray,total tumer close was 40 Gy/20F,with conventional fractionation regimen during the first two-thirds of the course,and followed by lcahr,1. 2 Gy per fraction,twice daily. The total close varied up to 65 Gy. Paclitaxel 30 mg was given through in stravenous dripping for weeky administrated once per week before radiotherapy for 6weeks with premedication of 1 hour intravenous infusion. Results The effective rate of concurrent chemotherapy group was 83. 3% ,1、3、5 year survival rates were 71. 4% 、42. 8% 、28. 5; short-term and effective rate of the radiotherapy was 63. 8% ,1、3 year survival rates were 47. 2% 、27. 7% 、13. 8% ,by chi-square test,the difference was statistically significant,two side effects are tolerable. Conclusion In comparison with HF,the combined treatment tends to promote the survival rate,yet does not increase the late adverse reactions.