【摘要】 目的比较后程加速超分割适形放疗联合化疗与单纯常规放疗治疗食管癌的临床疗效及副作用。方法93例食管癌患者随机分成单放组(45例)和放化组(48例)。放化组的化疗方案为:CF 200 mg,d1~5;5-Fu 500 mg/m2,d1~5;CDDP 25 mg/m2,d1~3;化疗结束后3~7 d开始放疗,放射治疗采用6 MV X线照射,先设前后野DT40~42 Gy/4~4.2周后,重复上述化疗方案,从第5周起进行加速超分割适形放疗,24~26 Gy/1.5~2周,放疗结束后再化疗2个周期。单放组采用全程常规分割1.8~2.0 Gy/(次.d),5次/周,DT60~70 Gy,6~7周完成。结果单放组和放化组有效率分别为62.2%和87.5%;1,3,5年生存率分别为65.8%和83.2%,23.2%和38.8%,10.2%和18.1%。中位生存期分别为9.8和15.2个月。两组比较差异有显著性P<0.05)。放化组发生放射性食管炎、WBC值下降等高于单放组。结论后程加速超分割适形放疗联合化疗治疗食管癌,可以提高疗效,延长生存期,虽毒副反应略增加,但患者均可耐受。更多还原

【Abstract】 Objective To study the comparative efficacy and toxicity between late course accelerated hyperfractionation stereotactic conformal radiotherapy combined with chemotherapy and conventional radiotherapy alone in treatment of esophageal cancer.Methods Ninty-three patients with esophageal cancer either inoperable or who refused operation were randomly divided into two groups:48 patients in group A were treated with late course accelerated hyperfractionation stereotactic conformal radiotherapy combined with chemotherapy（CT and RT）,45 patients in group B were treated with conventional radiotherapy alone（RT）.The chemotherapy regimen included CF 200 mg on d1-5,5-fluorouracil 500 mg/(m²·d) on d1-5 and cisplatin 25 mg/(m²·d) on d1-5 and was given before irradiation at 4 week intervals and repeated for 4 times.The survival rates were calculated by the Kaplan-Meier method and the difference of survival rates were evaluated with the SPSS 10.0 software in the χ²,t and log-rank tests.Results In the Group A（CR and TR）,the overall response（CR+PR） rate was 87.5%,and the 1-,3-,5-year survival rates were 83.2%,（38.8%） and 18.1% respectively with a median survival time（MST） of 15.2 months.In the Group B（RT）,the CR+PR rate was 66.2%,and 1-,3-,5-year survival rate were 65.8%,23.2% and 10.2% respectively,with a MST of 9.8 months.The difference between Groups A and B was statistically significant（P<0.05）.The incidence of major toxic effects,such as radiation esophagitis and myelosuppression,in Group A was higher than that in Group B.Conclusions The late course accelerated hyperfractionation stereotactic conformal radiotherapy combined with chemotherapy might improve the treatment efficacy of esophageal cancer and lengthen the survival time.The toxic and side effects of the combined modality were more severe than those of conventional radiotherapy alone,but they were well tolerable.更多还原