摘要
目的 :探讨中后程加速超分割放射治疗食管癌的疗效及早期放射反应和晚期损伤。方法 :本文对 5 9例食管鳞癌随机分为 2组 :常规分割放疗组 2 9例 ,2Gy/次 ,1次 /d ,5次 /wk ,总量 72Gy/7 2wk ;后程加速超分割放疗组 3 0例 ,前 1/2疗程同常规组 ,共 3 0Gy/3wk ,从第 4wk开始 2次 /d ,1 4Gy/次 ,间隔 6h以上 ,待总量达 4 1 2Gy时缩野至总量 72Gy/6wk。结果 :后加速组 1年生存率和局控率分别为 70 %和 73 9% ,明显高于常规组的 3 9 1%和 4 2 3 % (P <0 0 5 ) ;放疗结束后 3mo活检病理两组均为中、重度放疗反应 ,无显著性差异 (P >0 0 5 ) ;放疗结束时后加速组吞咽梗阻症状的改善优于常规组 ,有非常显著性差异 (P <0 0 1) ;放疗副反应后加速组稍多于常规组 ,但无显著性差异 ,晚期损伤后加速组也未见增加。结论 :研究初步表明 ,中后程加速超分割放射治疗能明显提高食管癌患者 1a生存率和局控率 ,不明显增加放疗副反应及晚期损伤。
Objective:To evaluate the effect of the accelerated hyperfractionation boost at the last three weeks of the radiotherapy course for esophageal carcinoma.Methods:59 patients with esophageal carcinoma were randomized into two groups:the conventional fractionation(CF) group (29 patients)and late course accelerated hyperfractionation (LCAH) group (30 patients).All were squamous cell carcinoma.Patients in CF received 2Gy per fraction,5 fractions a week to total dose of 72Gy in 7.2 weeks.Patients in LCAH received the 30Gy/3wk at fist,then followed by accelerated hyperfractionation with 1.4Gy per fraction,two fractions per day with 6 hours interval to a total dose of 41.2Gy in 3.8 weeks,then shrinked the fields to a total dose of 72 Gy in 6 weeks.Results:The one-year survival rates and local tumor control rates in LCAH group were significantly improved when compared to the CF group,being respectively 70% vs 39.1%,and 73.9% vs 42.3% .The improvement of swallowing obstruction symptoms in LCAH group was much better than that in CF group (P<0 01).There was no significant difference between two groups about clinical radiotherapy symptoms and biopsy irradiated.Conclusion:The preliminary results from our study in a small group of patients has shown that the one-year survival rates and local tumor control rates of patients with esophageal carcinoma can be improved by LCAH without increasing any complication.
出处
《内蒙古医学院学报》
1999年第3期164-166,共3页
Acta Academiae Medicinae Neimongol
基金
内蒙古自治区卫生科研资助
关键词
食管癌
加速超分割
中后程
放射治疗
esophageal carcinoma
accelerated hyperfractionation
intermediate-late course
radiotherapy
