摘要
目的 :评价前程加速超分割治疗食管癌放疗疗效及放射反应。方法 :对 96例食管癌随机分为前程加速超分割组 (前超组 )和常规组 ,每组 4 8例 ,全部经病理证实。男性 6 3例 ,女性 33例 ;年龄 4 1岁～ 70岁 ,中位年龄 5 7岁 ;病变部位胸上段 2 1例 ,胸中段 6 3例 ,胸下段 12例。病变长度 :<5cm 2 9例 ,5 0cm～ 7 0cm 5 7例 ,>10cm 10例。全部采用 6MVX线外照射 ,常规组 1次 /天 ,2 0Gy/次 ,5次 /周 ,总剂量 6 4Gy～ 6 8Gy ,4 4～ 4 5天完成。前超组 2次 /天 ,1 5Gy/次 ,间隔 6小时以上 ,总剂量 6 4～ 6 8Gy ,35～ 37天完成。 结果 :随访率 96 9%。 1、3、5年生存率前超组为 81 15 %、4 4 1%和 2 6 8% ,常规组为6 1 7%、2 5 1%和 16 9%。前超组 1、3年生存率高于常规组 (u值为 2 97及 2 6 4 ,P <0 0 1) ,5年生存率无显著意义 (u =1 71,P >0 0 5 )。前超组和常规组放射性食管炎发生率分别为 2 7 16和 16 7% (χ2 =1 5 2 ,P =0 2 0 ) ;放射性气管炎发生率前超组为 18 8% ,常规组为 12 5 % (χ2 =0 71,P =0 4 0 )。结论 :食管癌前程加速超分割治疗的 1年和 3年生存率高于常规组 ,5年生存率无明显差异 ,患者对前超组放疗副作用与常规组相比无明显增加。
Objective:To evaluate the effect and the radiation reaction of esophageal cancer patients treated by ECHR.Methods:96 patients of esophageal cancer were randomized into two groups,every group patients had pathology evidence.There were 63 males and 33 females.The ages ranged from 41 to 70 years with median 57years old.The patients with lesion in upper thoracic segment 21 cases,middle thoracic segment 63 cases,lower thoracic segment 12 cases.The length of lesions:<5.0cm 29 cases,5.0～7.0cm 57 cases,>0cm 10cases.They were randomly divided into two groups,The conventional radiation group(48 cases).And early course accelerated hyperfractionation(48 cases).Both groups were treated by 6mvx-ray external radiation.2.0 Gy every time each day,five times in each week in conventional group,the total dose 64～68Gy/32 fractions/44～45;in the early course accelerated hyperfractionation group.Twice each day with 1～5 Gy every time and with 6～8 hours,at first,dose 36～39Gy,and then 2.0Gy every time eachday,five times in each week,the total dose 64～68Gy/35～37d.Results:All patients were followed at more than five years.The follow-up rate was 96.9%.The survival rate of 1,3,5-year in early course accelerated hyperactionation group were 81.1%,44.1%,26.8% and 61.7%,25.1%,16.9% in conventional group respectively.The survival rate of ECHR is better than conventional group.Between the two groups,there was significant difference in the survival rate of 1,3-year (P<0.01),but there was no significant difference in the survival rate of 5-year(P>0.05).Conclusion:The result showed that the 1,3,5-year survival rate of ECHR of esophageal cancer is better than conventional radiotherapy.Between the two groups,there was significant difference in the survival rate of 1,3-year,However there is no significant difference in the survival rate of 5-year.It is well tolerated,without late side effects for long term survivors.
出处
《临床肿瘤学杂志》
CAS
2004年第5期496-498,共3页
Chinese Clinical Oncology
