摘要
目的探讨食管癌后程加速超分割照射剂量并观察长期疗效和并发症。方法480例食管癌病人随机分为6个组，每组80例，采用6MVX线外照射，常规分割放射治疗组（A组），1次，d，2．0Gy／次，5次／wk，总剂量68—70Gy：超分割放射治疗组（B、C、D、E、F组）在前2／3疗程常规放疗40Gy，后1，3疗程改用后程加速超分割照射，2次/d，每次分别为1．2Cy、1．3Gy、1．4Gy、1．5Gy、1．6Gy，间隔≥6h，5d／wk，总剂量68—70Gy。结果A、B、C、D、E、F组5a生存率分别为11．3％、16．3％、25．6％、30．0％、27．5％和26．3％（x^2=0．84、5．10、8．59、6．76、5．91）；局部控制率分别为30．0％、41．3％、45．0％、47．5％、53．8％和50．0％（x^2=2．21、3．84、5．16、9．27、6．67）。其急性放射性食管炎及气管炎的发生超分割组明显于常规组。结论后程加速超分割放疗提高了病人的长期生存率，单次剂量为1．3Gy-1．5Cy，总剂量为68—70Gy时急性反应病人能耐受，并未增加晚期并发症。
Objective To discuss the optimal radiation dose in the treatment of the late course accelerated hyperfractionation radiotherapy （LCAHR） for esophageal carcinoma, focusing on the difference the long term results and complications. Methods 480 patients with esophageal carcinoma were randomized into six groups （80 patients every group）. All patients were given with 6MVX-ray. The conventional fractionation group （A group） received routine radiotherapy 2.0Gy per day, 5 times a week to a total dose of 68-70Gy. The LCAHR groups （B, C, D, E, and F group） were give with -conventional fractionation regimen during the first two-thirds of the course, total tumor dose was 40Gy, and followed by LCAHR, 1.2Gy, 1.3Gy, 1.4Gy, 1.5Gy, and 1.6Gy per fraction, twice daily （interval of 6hrs）, 5 days per week to a total dose of 68-70Gy. Results The 5- year survival rates were 11.3%, 16.3%, 25.6%, 30.0%, 27.5%, and 26.3% （x^2=0,84, 5.10, 8.59, 6.76, and 5.91） in Group A, B, C, D, E, and F; The 5- year local control rates were 30.0%, 41.3%, 45.0%, 47.5%, 53.8%, and 50.0% （x^2=2.21, 3.84, 5.16, 9.27, 6.67）. The acute radiation-induced esophagitis and tracheitis rates were higher in LCAHR groups than in Group A. Conelnsions The LCAHR can increase the long survival rate in patients with esophageal carcinoma. The patients are irradiated 1.3Gy-l.5Gy/f per time, and to a total dose of 68-70Gy, they can tolerate it well and the therapy don＇t increase the late complications.
出处
《世界肿瘤杂志》
2007年第1期40-41,43,共3页
Tumour Journal of the World
关键词
食管肿瘤
超分割放射治疗
放射剂量分次
Esophgeal neoplasms
hyperfraction radiotherapy
dosage fractionation
