三维适形后程加速超分割放射治疗中晚期食管癌  

Three dimensional conformal radiotherapy with late course accelerated hyper-fractionation for ad- vanced esophageal carcinoma

作　　者：朱卫国[1] 韩济华[1] 彭进[1] 

机构地区：[1]南京医科大学附属淮安第一医院,淮安市第一人民医院放疗科,江苏淮安223300

出　　处：《肿瘤研究与临床》2007年第10期684-686,共3页Cancer Research and Clinic

摘　　要：目的探讨三维适形(3DCRT)后程加速超分割放射治疗中晚期食管癌的疗效及毒副作用。方法采用3DCRT 后程加速超分割放射治疗食管癌患者55例(2.0 Gy/次,5次/周,剂量36 Gy 后改1.5 Gy/次,2次/d,总剂量66 Gy)与后程加速超分割放射治疗(CF)的60例食管癌患者进行比较。结果 3DCRT 组和 CF 组的1、2、3、4年生存率分别为63.6%、50.9%、38.2%、30.9%和58.3%、38.3%、33.3%、23.3%(x^2=4.44,P=0.031);3DCRT 组和 CF 组的1、2、3、4年局部控制率分别为72.7%、58.1%、47.2%、36.3%和53.3%、40%、28.3%、20%(x^2=5.33,P=0.013)。3DCRT 组的急性放射性食管炎和 CF 组相似,急性气管炎及血液毒性两组相似。CF 组的晚期肺损伤较3DCRT 组重(x^2=4.42,P=0.012)。结论 3DCRT 能明显提高中晚期食管癌的局部控制率和生存率,放射性反应较轻。Objective To evaluate the results and toxic effects in three dimensional radiotherapy (3DCRT)with late course accelerated hyper-fractionation for advanced esophageal carcinoma.Methods From December 2001 to December 2003,115 patients were randomly divided into two groups:in 3DCRT group,55 patients were given late course accelerated hyper-fractionation radiotherapy to a total close of 66 Gy (2.0 Gy per fraction,5 times per week;to a dose of 36 Gy were changed into 1.5 Gy/f,2 f/d).In CF group,60 patients were given late course accelerated hyper-fractionation radiotherapy to a total dose of 66 Gy.Results The 1-, 2-,3-,4-year survival rates in 3DCRT group were 63.6 %, 50.9 %, 38.2 %, 30.9 % compared to 58.3 %, 38.3 %,33.3 %,23.3 % in CF group(X^2=4.44,P=0.031),and local control rates in 1-,2-,3-,and 4- years in 3DCRT group were 72.7 %,58.1%,47.2 % and 36.3 %,compared to 53.3 %,40 %,28.3 %,and 20 %(X^2=5.33,P=0.013)in CF group.However,in the 3DCRT group,the incidence of acute esophagitis was similar to CF group; hematogenous toxic and acute bronchitis were similar between the two groups. Late course lung injury in CF group was higher than that in 3DCRT group.Conclusion 3DCRT is able to improve the local control rate and survival rate,and unable to improve acute and late radiation toxie effects.

关 键 词：食管肿瘤 放射治疗 计算机辅助 治疗结果 

分 类 号：R735.1[医药卫生—肿瘤]