食管癌后程加速超分割放疗加卡莫氟增敏的临床研究  

Late accelerated hyperfractionated radiotherapy combined with HCFU for esophageal carcinoma

作　　者：王会忠[1] 王坤[1] 荐鲁霞[1] 

机构地区：[1]胶南市人民医院内科,山东胶南266400

出　　处：《中华肿瘤防治杂志》2006年第5期368-371,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的：比较后程加速超分割放疗加口服卡莫氟、后程加速超分割放疗及常规放射治疗食管癌的近期疗效，以及卡莫氟的增敏作用。方法：对90例食管鳞癌患者采用信封法随机分成3组。常规分割（CF）组31例，2．0Gy／次、5次／周，总剂量60～68Gy；后程加速超分割（LCAF）组29例，先常规照射至40Gy后改为2次／d、1.3Gy／次，间隔6h，总剂量62～69Gy；后程加速超分割合并口服卡莫氟（LCAF＋C）组30例，照射方法与LCAF组相同，放疗开始同步口服卡莫氟200mg／次、3次／d，至放疗结束。结果：CF、LCAF和LCAF＋C组的近期疗效分别为74．2％（23／31）、86．2％（25／29）和96．7%（29／30）;局部控制率分别为54．8％（17／31）、79．3％（23／29）和90．0％（27／30）；1年生存率分别为51．6％、75．9％和86．7％。LCAF＋C组优于LCAF组，x^=7．92，P=0．024；LCAF组优于CF组，x^2=6．27，P=0．038。急性毒副反应LCAF＋C组略高于LCAF组，两者均高于CF组，但三者之间差异无统计学意义，x^2=0．78，P=0．093。3组死于远处转移的比率差异无统计学意义。结论：卡莫氟时食管癌放疗有增敏作用，同后程加速超分割放疗结合应用能提高食管癌的局部控制率和生存率。OBJECTIVE：To evaluate the effect of late accelerated hyperfractionated radiotherapy （LACF） combined with compound polyphase liposome of HCFU on esophageal carcinoma. METHODS： Ninety patients of esophageal cancer were randomly divided into 3 groups, which included radiotherapy alone group （CF） that received conventional irradiation to a total of 60-68 Gy, LCAF group which recived conventional fractionated radiotherapy during the first two-thirds of the treatment to a dose about 40 Gy/（20 F · 4 W）, then followed by late accelerated hyperfractionaed radiotherapy, twice daily radiotherapy at 1.3 Gy perfraction to total dose about 62--69 Gy,and LCAF＋C group （Late accelerated hyperfractionaed radiotherapy combined with compound polyphase liposome of HCFU）, in which patients were treated as the same as the LCAF groups, execpt that they were treated with compound liposome of HCFU （200 mg po tid） from beginning of radiotherapy to the end. RESULTS： The short-term effects of the 3 groups were 74.2%（23/31）,86.2%（25/29） and 96. 7% （29/30） respectively, the tumor local control rates and one-year survival rates of the 3 groups were 54.8%,51.6% ;79.3%,75.9% and 90. 0%,86.7% respectively. The effect of LCAF＋C group was better than those of LCAF group （x^2 =7.92,P=0. 024） and CF group （LCAF vs CF, x^2= 6.27, P= 0. 038）. The accidents of acute trachetis and acute esophagitis in LCAF＋C group and LCAF group were higher than those in CF group, but there was no stastistically significant difference between the 2 groups,x^2 = 0. 78, P = 0. 093. There was no stastistically significant diffencence in distant metastasis in the 3 groups. CONCLUSION： Compound polyphase liposome of HCFU, as a effective chemosensitizater combined with late accelerate hyperfractionated radiotherapy can improve the short-term effects of esophageal carcinoma, though the acute reaction in LCAF＋ C group is more than that of conventional irradiation.

关 键 词：食管肿瘤/放射疗法 食管肿瘤/化学疗法 综合疗法 

分 类 号：R735.1[医药卫生—肿瘤] R730.55[医药卫生—临床医学]