中上段食管癌后程加速超分割放疗加同期化疗的临床观察  

Clinical Observation of Combination of Late Course Accelerated Hyperfrationation Radiotherapy with Chemotherapy in Treating Mid-upper Esophageal Carcinoma

作　　者：偰燕燕[1] 

机构地区：[1]江苏省镇江市第一人民医院肿瘤科,212002

出　　处：《齐齐哈尔医学院学报》2007年第15期1797-1798,1801,共3页Journal of Qiqihar Medical University

摘　　要：目的比较后程加速超分割放疗加同期化疗与单纯后程加速超分割放疗治疗中上段食管癌的近期疗效及毒副作用。方法60例中上段食管癌病人随机分为两组。1)单纯后程加速超分割放疗(late course accelerated hyper fractionation radiotherapy,LCAFR)组30例,首先予前后对穿照射,分割剂量2GY/次,5次/周。DT40GY后缩野,避开脊髓,改为斜野或侧野照射,分割剂量1.1～1.2GY/次,2次/天(间隔6小时以上),使肿瘤总量达65GY左右。2)后程加速超分割放疗加同期化疗(LCAFR+C)组30例,同LCAFR组并加用顺铂20mg静滴,第1～5天、第28～32天;优福啶3片/次,3次/日,口服至放疗结束;同时予止吐第对症支持治疗。结果进食梗阻症状改善情况,LCAFR+C组为(31.8±8.0)GY,LCAFR组为(35.8±8.0)GY,经t检验,t0.05(70)=1.994<t=2.118<t0.01(70)=2.648,P<0.05,有显著性差异。治疗结束影像学表现。LCAFR+C组为83.3%(25/30),LCAFR组为60.0%(18/30)有显著性差异,P<0.05。毒副反应两组患者无明显差异。结论后程加速超分割放疗加同期化疗治疗中上段食管癌症状改善快,提高了治疗强度,且多种治疗的同时介入,时间上不存在对局部病灶和转移灶的治疗延迟。Objective To evaluate the toxicity and clinical activity of late course accelerated hyper fractionation radiotherapy plus chemotherapy （LCAHR＋C） and late course accelerated hyper fractionation radiotherapy （LCAHR）, Methods 60 patients with mid-upper segment esophageal carcinoma were randomly divided into two groups： 1） LCAFR group： 30 patients received 2Gy per day, 5 times a week, till DT 40Gy. Then traditional radiotherapy was applied and kept away with vertebral canal, 1.1-1.2Gy per fraction, 2 times per day（interval of six hours）,to a total dose of 65 Gy. 2）LCAHR＋C group：30 patients were received the same radiotherapy as LCAHR, supplement with concurrent chemotherapy. The chemotherapy regimen was： consecutive intravenous infusion of cisplatin（DDP） 20mg/d for days1-5 and 28-32, uracil-ftorafur （UFT） 3 piece per time, 3 times per day, till the end of radiotherapy. Results Eating obstruction symptom improvement was （31.8±8.0） Gy and （35.8±8.0） Gy in LCAFR＋ C group and LCAHR group respectively. There was significant difference between two groups （P 〈 0.05）. Change imaging was 83.3% （25/30） in LCAFR＋C group and 60% （18/30） in LCAFR group significantly different （P 〈 0. 05）. Adverse effect had no statistical difference in two groups. Conclusions With LCAHR plus concurrent chemotherapy treating mid- upper segment esopha- geal carcinoma, the symptom improved immediately, treatment intension is elevated. There was no delay in local focus and metastasis due to manifold treatments.

关 键 词：中上段食管癌 放疗 化疗 

分 类 号：R739.630.5[医药卫生—肿瘤]