摘要
目的比较常规分割、后程加速超分割及全程加速超分割放疗胸中下段食管中分化鳞癌的疗效与副反应。方法将90例患者随机分成3个组：(1)常规分割(CF)组,2．0Gy/次,1次/d,5d/周,总量70Gy；(2)后程加速超分割(LCAF)组,先常规分割放疗40Gy,后1．5Gy/次,2次/d,间隔>6h,5d/周,加量至70Gy；(3)全程加速超分割(WCAHF)组,1．5Gy/次,2次/d,间隔＞6h,5d/周,总量至72Gy。结果CF和LCAF及WCAHF组1、2、3年局部控制率分别为47%、17%、0%和60%、20%、20%及60%、40%、33%,WCAHF组局部控制率明显高于CF、LCAF组(P＜0．01)。CF和LCAF及WCAHF组1、2、3年生存率分别为47%、20%、10%和63%、43%、17%及63%、50%、33%。WCAHF、LCAF组的2、3年生存率明显高于CF组(P＜0．01)。急性副反应WCAHF、LCAF组较CF组严重,WCAHF和LCAF组急性放射性食管炎2～3级明显高于CF组,但晚期放射性食管炎3个组无差异。WCAHF组1～2级急性放射性肺炎高于LCAF、CF组,且WCAHF组1例因放射性肺炎而导致死亡。结论WCAHF组能提高食管癌的局部控制率和2、3年生存率,但副反应稍有增加。
Objective To compare the treatment effects and toxicity of convention fractionation radiotherapy （ CFR）, late course accelerated hyperfractionation radiotherapy （LCAFR） and whole course accelerated hyperfractionation radiotherapy（WCAFR） for patients with middle or low thoracic esophageal moderately differentiated squamous cell carcinoma. Methods Ninety patients with middle or low thoratic esophageal carcinoma were divided into three groups： 1. CFR group, patients were irradiated 2.0 Gy/f, 5 times a week, to a total dose ofT0 Gy; 2. LCAFR group, patients were first irradiated with CFR to 40 Gy, then followed by 1.5 Gy/f bid, at more than 6 hoursinterval, 5 times a week, to a total dose of 70 Gy;3. WCAFR group, patients were irradiated 1.5 Gy/f bid, at more than 6 hoursinterval, 5 times a week, to a total dose of 72 Gy. Results The 1-,2-,3-year local control rate was 47% ,17% and 0% in CFR group,60% ,20% and 20% in LCAFR group,60% ,40% and 33% in WCAFR group, respectively. The 1-,2-,3-year survival rate was 47% ,20% and 10% in CFR group,63% ,43% and 17% in LCAFR group,and 63% ,50% and 33% in WCAFR group, respectively. There were better results in the latter two groups（P 〈0.01 ）. The acute toxic effect was severer in the WCAHF and LCAF groups than in CF group. Highter grade 2-3 acute esophagitis rate was observed both in WCAHF and LCAF groups. There were no significant differences in late esophagitis rate between the three groups. The grade 1-2 acute radiation pneumonitis rates were higher in WCAHF group than in LCAF and CF groups. One patient died of radiation pneumonitis in WCAHF group. Conclusions Whole course accelerated hyperfractionation radiotherapy can significantly improve the local control rates and the 1- and 2- year survival rates of esophageal cancer , but can also increase the toxicity.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2006年第5期384-387,共4页
Chinese Journal of Radiation Oncology
关键词
食管肿瘤/放射疗法
放射剂量分次
预后
Esophageal neoplasms/radiotherapy
Dosage fractionation
Prognosis
