【摘要】 目的:探讨逐级加量全程加速超分割和后程加速超分割治疗食管癌的疗效和毒性。方法:100例符合入组条件的食管鳞癌病例随机分为逐级加量全程加速超分割放疗组(全程组)和后程加速超分割放疗组(后程组)各50例。后程组前4周常规放疗,每天照射1次,DT40Gy,20次,后2周超分割放疗,每天照射2次,每次DT1.5Gy,间隔6～8小时,DT30Gy,总剂量DT70Gy,40次,40～45天;全程组采用全程超分割放疗,每天照射2次,间隔6～8小时,第1、2周每次照射DT1.2Gy,第3、4周每次照射DT1.4Gy,第5周每次照射DT1.6Gy,总剂量DT68Gy,50次,34～38天。结果:全部病例随访率100%。全程组和后程组的1、2、3年局部控制率分别为78.5%、72.8%、70.8%和77.7%、69.1%、55.3%(P=0.054);1、2、3年生存率分别为94%、64%、50%和84%、60%、37%(P=0.049)。急性反应和后期损伤无明显差异(P>0.05)。结论:逐级加量全程加速超分割提高了食管癌放疗的局控率,有可能提高长期生存率。正常组织急性反应和晚期放射损伤并没有增加。更多还原

【Abstract】 Objective:To compare the responses and side effect of escalated whole course accelerated hyperfractionated(EWCAF) regimen and late course accelerated hyperfractionated(LCAF) regimen in the radiotherapy for esophageal carcinoma. Methods:One hundred patients with squamous cell carcinoma of the esophagus were randomized into two groups:50 in the EWCAF and 50 in the LCAF group. The LCAF group received conventional fractions in the first part of the treatment to a dose of 40Gy/20f,followed by accelerated hyperfractionation irradiation with a dose of 30Gy,twice daily at 1.5Gy per fraction with a minimum interval of 6-8 hours between fractions. The total dose was 70Gy/40f,40-45days. The EWCAF group,in the first and second week twice daily dose at 1.2Gy per fraction was given,then in the 3rd and 4th week twice daily dose at 1.4Gy per fraction was given,in the 5th week twice daily dose at 1.6Gy per fraction was given,the total dose was 68Gy/50f,34-38days. Results:The follow-up rate was 100%. The local control rates of 1-,2-and 3-year were 78.5%,72.8%,70.8% in the EWCAF group and 77.7%,69.1%,55.3% in the LCAF group(P=0.054). The survival rates of 1-,2-and 3-year were 94%,64%,50% in the EWCAF group and 84%,60%,37% in the LCAF group(P=0.049). There was no significant difference in the acute side effect and late complications between the two groups(P>0.05). Conclusion:EWCAF probably improved the local control and the survival rates,and don’t increase the acute side effect and the late complications.更多还原