加速超分割放射治疗食管癌的临床初步观察  

Clinical Study of Hyperfractionated Accelerated Radiotherapy for Esophageal Carcinoma

作　　者：郭小毛[1] 刘瑛[1] 

机构地区：[1]上海医科大学附属肿瘤医院

出　　处：《实用癌症杂志》1998年第1期57-58,共2页The Practical Journal of Cancer

摘　　要：为了观察加速超分割放射治疗食管癌的耐受性和临床效果，作者自１９９２年１０月至１９９３年５月，将４０例胸段食管鳞癌病人随机分为加速超分割放射治疗组（２０例）和常规放射治疗组（２０例）。常规组１．８Ｇｙ／次，总量７０．２Ｇｙ，３９次，５５天。加速超分割组分为二个阶段：第一阶段１．１Ｇｙ／次，２次／日，间隔至少６小时，总剂量为３０．８Ｇｙ，２８次，２０天；第二阶段３次／日，１．１Ｇｙ／次，间隔４～６小时，总量３３Ｇｙ，３０次，１４天。两阶段总量６３．８Ｇｙ，５８次，３４天。近期疗效分析，加速超分割组ＣＲ５０％，常规组ＣＲ３０％。ＣＲ＋ＰＲ分别为９０％和９５％。预计治疗增益因子１．１３。急性反应主要为Ⅰｏ和Ⅱｏ食管炎，加速超分割组（１８／２０）发生率明显高于常规组（４／２０），但患者均能耐受。３年随访率为１００％，超分割组３年生存率４０％（８／２０），常规组２０％（４／２０），Ｐ＜０．０１，有非常显著性差异。初步结果显示加速超分割放射治疗食管癌，可望提高生存率，病人能耐受，作者认为此方案是可行的。To observe the feasibility and treatment effect of hyperfractionated accelerated radiotherapy for esophageal carcinoma,forty patients with esophageal carcinoma were randomized into hyperfractionated accelerated radiation therapy (HART) group (20 cases) and conventional radiotherapy group (20 cases) from October 1992 to May 1993. The conventional radiotherapy was given fraction dose 1.8 Gy once a day and to a total dose of 70.2 Gy/39 fractions/55 days. The HART course was divided into two stages:the first,it was fraction dose of 1.1 Gy,given twice a day,with 6 hours interval,and the tolal dose was 30.8 Gy/28 frations/20 days,the second, it was 1.1 Gy per fraction given three times per day to a total dose of 33 Gy/30 fractions/14 days. The total dose of two stages was 63.8 Gy/58 fractions/34 dasys. CR+PR in HART group (90%) was siminal to that in conventional radiotherapy group (95%). The acute reaction was mainly Ⅰo,Ⅱo esophagitis in HART group (90%) and in control group (20%),but there were no Ⅲo or Ⅳo reactions observed in all the trial.All patients were followed up for 3 years.The threeyear survival rate was 40%(8/20) in HART group and 20%(4/20) in conventional radiotherapy group and there was statistically significant difference (P<0.01) No late reactions could be observed in the trail.The results show that the HART can improve the survival rate in esophageal carcinoma and reactions were tolerable.Thus, such a regimen is feasible in our patients.

关 键 词：食管肿瘤 加速超分割 放射疗法 

分 类 号：R735.105[医药卫生—肿瘤]