后程加速超分割放射治疗食管癌

目的探讨后程加速超分割放射治疗食管癌的临床疗效和不良反应。方法将120例食管癌随机分为后程加速超分割组(后超组)和常规组,每组60例。所有病例病理诊断明确、均为鳞癌。采用60Co常规3个野照射,常规组2.0Gy/次、1次/d,5次/周,总剂量70Gy,35分次,7周完成;后超组前程2.0Gy/次、1次/d,5次/周,剂量达40Gy后改为1.5Gy/次,2次/d,间隔6h以上,10次/周,总剂量为70Gy,40分次,6周完成。结果随访率为100%。1、3、5年生存率后超组为81.6%、45%、28.3%,常规组为61.6%、23.3%、10%。后超组明显好于常规组(P<0.05)。两组放疗不良反应无差别,其主要死亡原因为局部复发,其次为出血、穿孔及远处转移。结论后程加速超分割能明显提高食管癌患者1、3、5年生存率,不增加放疗不良反应及并发症。

Treatment of Esophageal Carcinoma by Late- course Accelerated Hyperfractionation Radiotherapy

Objective To investigate the efficacy and diverse response of the treatment of esophageal carcinoma by late-course accelerated hyperfractionation(LCAH) radiotherapy.Methods All 120 cases with esophageal cancer were randomly divided into the late-course accelerated hyperfractionation group(LCAH group) and the conventional group,each containing 60 cases.The pathogenic diagnosis for all the cases were clear,all being with squamous cancer.All of them received conventional ~(60)Co three-field radiation.The cases in the conventional group underwent 2.0Gy/1f,1f/d,5f/week,total doses reached 70Gy by 35 times,which should be finished within 7 weeks.And the cases in the LCAH group experienced 2.0Gy/1f,1f/d,5f/week for the first part of treatment course.When total quantity of 40Gy was reached,it should be changed into 1.5Gy/1f,2f/d,interval period over 6 hours,10f/week.Total doses came to 70Gy by 40 times,which should be over within 6 weeks.Results The follow-up rates were 100%.The survival rates for 1,3 and 5 years were 81.6%,45% and 28.3% respectively in the LCAH group.And those in the conventional group were 61.6%,23.3% and 10% respectively.The LCAH group was better than the conventional group(P<0.05).There was no difference of adverse response between the two groups.Their major causes of death were due to local relapse,next due to hemarrage,perforation and remote metastasis.Conclusion The late-course accelerated hyperfractionation radiotherapy can obviously improve the survival rates of 1,3 and 5 years for the cases with esophageal cancer,and also do not increase adverse responses and complications.