后程加速超分割放疗结合化疗治疗96例中、晚期食管癌  

Hyperfractionated radiotherapy combined with chemotherapy for advanced esophageal carcinoma

作　　者：马红兵[1] 康华峰[1] 王西京[1] 张晓智[2] 安怀伦[2] 

机构地区：[1]西安交通大学附属第二医院肿瘤科,陕西西安710004 [2]西安交通大学附属第一医院肿瘤放疗科,陕西西安710068

出　　处：《中国癌症杂志》2003年第1期45-48,共4页China Oncology

摘　　要：目的 :评价后程加速超分割放疗结合化疗治疗中、晚期食管癌的临床疗效。方法 :1 76例中、晚期食管癌 ,根据不同的治疗方法分为两组 :单纯根治性放射治疗组 (单放组 )和后程加速超分割放疗结合化疗组 (综合放化组 )。单放组共 80例 ,采用常规设野放疗。照射剂量为 64～ 70Gy。综合组共 96例 ,放射方法均为前 2 3疗程常规放疗 ,每次2 .0Gy,共 40Gy ;后 1 3疗程缩野改为加速超分割放射治疗 ,每天 2次 ,1 .3Gy 次 ,共 2 4～ 30Gy;化疗采用PF方案[顺铂 (DDP) 2 0mg 次静脉点滴 ,第 1～ 5天 ;氟尿嘧啶 (5 FU) 750mg 次静脉点滴 ,持续 8小时以上 ,第 1～ 5天 ,2 8天为 1周期 )。两组均随访 5年 ,失访 1 7例 ,随访率 90 .3 %。结果 :原发灶的近期疗效综合放化组好于单放组 ,两组间差异有显著性 (P <0 .0 5) ;锁骨上淋巴结转移灶的近期疗效两组间差异无显著性 (P >0 .0 5) ;综合放化组与单放组一、三、五年生存率分别为 69.8%、51 .1 %、2 9.2 %和 46 .3 %、2 1 .3 %、1 1 .3 % ,综合组疗效明显好于单放组 ,一、三年生存率两组间差异有显著性 (P <0 .0 5) ,但五年生存率两组间差异无显著性 (P >0 .0 5)。局部控制率综合放化组明显高于单放组 (P <0 .0 5) ,远处转移率两组相近。综合组的急性放射性气管炎和急性?Purpose:To evaluate the effect of late accelerated hyperfractionated radiotherapy (LCAHFR) combined with chemotherapy on advanced esophageal cancer.Methods:176 cases of advanced esophageal cancer were treated from March 1994 to March 1997.Patient were divided into 2 groups, including radiotherapy alone group (80 cases) receiving conventional irradiation to a total of 64～70 Gy and combined treatment group (96 cases) which received LCAHFR groups plus chemotherapy with PF regimen. Combined treatment group patients were treated with conventional fractionated radiotherapy during the firs two thirds of the treatment to a dose about 40 Gy/20 F/4 weeks. This was followed by accelerated hyper fractioned radiotherapy using reduced fields, twice daily at 1.5 Gy per fraction to a dose about 24～30 Gy.All cases of the combined treatment group were treated with PF(DDP 20 mg iv drip on days 1 to 5,and 5 FU 750 mg iv drip on days 1 to 5,Every 28 days as one cycle).All patients were followed for ≥ 5 years.Results:The short term results of LCAHFR combined with chemotherapy was better than that of radiotherapy alone. The difference between these two groups was statistically significant( P <0.05).The difference of the short term results of the supraclavicular lymph node between these two groups was not statistically significant( P >0.05).The one , three and five year survival rate were 69.8%,51.1%,29.2% in combined group and 46.3%,21.3%,11.3% in simple irradiation alone group. The survival rates in the combined group were much better than those in simple radiotherapy group( P <0.05).The local control rates in the combined treatment group were much better than those in simple radiotherapy group( P <0.05). There was no significant different in distant metastasis between the two groups. The acute tracheitis and acute esophagitis in the combined treatment group was more than that in the simple group( P <0.05).Conclusions:Late course accelerated hyperfractionated radiotherapy for advanced esophageal is effective and

关 键 词：食管肿瘤 放射疗法 超分割放射治疗 综合放化疗 

分 类 号：R735.1[医药卫生—肿瘤]