不均等剂量分割放射治疗食管癌的研究  

RESEARCH ON IRREGULAR FRACTIONATED IRRADIATION OF ESOPHAGUS CANCER

作　　者：万志龙[1] 马煌如[1] 季秀珍[1] 蔡晶[1] 曹金山[1] 龚振厦[1] 

机构地区：[1]江苏省南通市肿瘤医院放疗科,通州226361

出　　处：《南通医学院学报》2002年第1期18-19,21,共3页ACTA Academiae Medicinae Nantong

基　　金：江苏省卫生厅资助项目 (编号 970 5

摘　　要：目的 :评价不均等剂量分割放射治疗食管癌的疗效。方法 :食管鳞癌 12 0例随机分为两组 ,( 1)常规分割组 60例 ,方法为 2 0 0 c Gy/次 ,5次 /周 ,总剂量为 660 0 c GY共 3 3次 ,6～ 7周完成 ;( 2 )不均等剂量分割 60例 ,方法为周一上午胸前垂直野 ( A) 2 5 0 c GY,间隔 6h,胸背垂直野 ( A) 2 5 0 c Gy。周二～五 ,胸背二侧野 ( C、D)轮照 ,每天 14 0 c Gy/次 ,周六周日休息 2天重复上周治疗 ,肿瘤量 5 3 0 0 c Gy共 3 0次 ,3 5天完成。改缩胸前侧野 ( E、F)照射 ,方法同前 ,照射剂量 10 60 c Gy共 6次 ,总剂量为 63 60 c Gy,共 3 6次 ,4 2天完成。结果 :1、2、3年生存率 :不均等组 71.7%、5 0 .0 %及3 1.7% ,常规组 4 6.7%、3 5 .0 %及 2 0 .0 % ,两组比较差异有显著性 ( P<0 .0 5 ) ;而放射治疗副反应和并发症两组差异无显著性 ( P>0 .0 5 )。结论 :不均等分割放射治疗能明显提高食管癌患者的局部控制率和长期生存率 ,不明显增加放射治疗副反应及并发症。Objective:To evaluate the therapeutic effects of irregular fractionated irradiation on esophageal carcinoma.Methods:Sixty patients were given irregular fractionated irradiation.They received 250cGy through field(A)on Monday mornings,once six hours,and 250cGy through field(B),From Tuesday to Friday,an alternative irradiation took place through fields C and D Treatment was continued,the dose schedule was 5300cGy,given 30 times for 35 days.The irradiation through field E and field F was the same as that through fields C and D.They were given a dose of 1060cGy six times weekly,The total dose was 6360cGy given 36 times for 42 days.And 60 patients were the ones of control group;in whom conventional fractionation irradiation was carried out five times every week.An alternative irradiation through one field was performed every day,with a dose of 200cGy for each one.After two days' rest,such in irradiation was repeated,the total dose was 6600cGy given thirty-three times for 45 days.Result:the 1-,2-,3-year survival rates were 71.7%,50.0%,31.7% in the irregular fractonated irradiation and 46.7%;35.0%;20.0% in the conventional group(P<0.05),there was no significant difference on acute complications or specific sequelae between the two groups.Conclusions:The results from this study show that the irregular fractionated:irradiation regimen can notably improve the long-term survival of esophageal carcinoma without increasing any untoward radioreactions or complications.

关 键 词：食管癌 放射疗法 常规分割 不均等分割 治疗 研究 

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